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Nephrology Xagena

High incidence of pulmonary arterial hypertension in end-stage renal disease patients undergoing continuous ambulatory peritoneal dialysis


Pulmonary arterial hypertension ( PAH ) is a major complication in renal failure patients, but very little information is available on the cardiovascular parameters in these patients.
The prevalence and risk factors for pulmonary arterial hypertension were systematically evaluated in patients with end-stage renal diseases ( ESRD ) undergoing continuous ambulatory peritoneal dialysis ( CAPD ).

During 2010-2014 period, 177 ESRD patients ( 85 males and 92 females ) undergoing CAPD therapy were recruited.

. Study participants consisted of 65 patients ( 36.52% ) with pulmonary arterial hypertension ( PAH group ) and 112 patients without pulmonary arterial hypertension ( non-PAH group ).

The interdialytic weight gain, systolic blood pressure and diastolic blood pressure ( DBP ), mean arterial pressure and hypertensive nephropathy incidence in the PAH group were significantly higher than the non-PAH group ( all p  less than  0.05 ).

There were significant differences between PAH group and non-PAH group in C-reactive protein-positive rate, N-terminal pro-brain natriuretic peptide ( NT-proBNP ), hemoglobin, prealbumin and serum albumin levels ( all p  less than 0.05 ).

Compared with non-PAH group, PAH group showed significant increases in right ventricular internal diameter ( RVID ), right ventricular outflow tract diameter ( RVOTD ), main pulmonary artery diameter, left atrial diameter ( LAD ), left ventricular end-diastolic diameter, interventricular septal thickness, left ventricular mass index, early diastolic mitral annulus velocity and valve calcification incidence ( all p  less than 0.05 ), and decreased left ventricular ejection fraction ( LVEF ), tricuspid annulus plane systolic excursion ( TAPSE ) and early diastolic blood flow peak and mitral annulus velocity ( E/E' ) ( all p  less than  0.05 ).

Logistic regression analysis revealed that DBP, NT-proBNP, LAD, RVID, RVOTD, LVEF, TAPSE and E/E' are major risk factors for pulmonary arterial hypertension.

In conclusion, a high incidence of pulmonary arterial hypertension in ESRD patients undergoing continuous ambulatory peritoneal dialysis was observed.
Logistic regression analysis revealed that DBP, NT-proBNP, LAD, RVID, RVOTD, LVEF, TAPSE and E/E' are high-risk factors for pulmonary arterial hypertension in ESRD patients undergoing continuous ambulatory peritoneal dialysis. ( Xagena )

Zhang L et al, Ren Fail 2016; Epub ahead of print

XagenaMedicine_2016



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