The Prevalence and Correlates of Pulmonary Hypertension in End Stage Renal Disease

Objective; To evaluate the incidence of unexplained pulmonary hypertension (PH) in end- stage renal disease(ESRD) and to evaluate its possible relationship with some clinical and biochemical parameters.Patients and Methods; This study was conducted retrospectively at Prince Rashed Hospital (PRH), North ofJordan, on patients undergoing maintenance hemodialysis (HD) during August 2009 to August 2010.Demographicand clinical data were obtained from charts review and Patients themselves. 2Dimensional echocardiography(2DECHO) was performed in all patients. Blood samples were taken for parathormone (PTH) and other biochemicalmeasurements. SPSS package was used for statistical analysis.Statistical significance was considered at p value <0.05.Results; A total of 131 hemodialysis (HD) patients were included in the study, of them 76 (58, 9%) were men. Themean age of the study population was 53.7 + 16.2 yrs. Pulmonary hypertension (pulmonary artery pressure(PAP)=47+3, range 35-79mmHg) was detected in 52 patients (39.6%).The levels of PAP were positively correlatedwith serum intact parathormone (iPTH) levels, age, duration of HD, mean arterial pressure (MAP), interventricularseptal (IVS) thickness, cardiac output(CO), and serum levels of phosphorus , creatinine, whereas the levels of PAPwere inversely correlated with the levels of serum calcium and hemoglobin(Hb).Conclusion; Pulmonary hypertension is a frequent finding in end stage renal disease and mineral disorders togetherwith secondary hyperparathyroidism (SHPTH), increased cardiac output and anemia may be involved in thepathogenesis of this abnormality. The early detection and treatment of pulmonary hypertension aiming to decreaseits serious complications is mandatory.

Keywords:

Pulmonary hypertension , mineral metabolism , echocardiography , end- stage renal disease. Prince Rashed Hospital