Pulmonary hypertension (PHT) has been reported to occur in a considerable proportion of patients with end stage renal disease (ESRD). It is a progressive condition of the pulmonary circulation and poses prognostic importance. In this study we sought to investigate the prevalence and the predictors of PHT in patients with ESRD undergoing renal transplantation. The records of 500 adult patients who underwent renal transplantation at our institution were retrospectively evaluated. Clinical and demographic data and laboratory results were noted. A comprehensive Doppler echocardiographic examination was performed to all patients as part of the preoperative assessment. Systolic pulmonary artery pressure (SPAP) was calculated using Bernoulli equation and a value of >30mmHg was accepted as PHT. The mean age of the study population was 31.6 ± 10.2 years. The mean duration of dialysis was 40 months, and 432 patients (86.4%) were on hemodialysis (HD), 68 (13.6%) were on peritoneal dialysis (PD). PHT was detected in 85 (17%) patients, the mean SPAP of whom was 46.7 ± 8.7mmHg (range: 35-75mmHg). The mean age, sex, laboratory variables were similar between patients with and without PHT (P>0.05 for all). The mean duration of dialysis therapy was longer in PHT group than those with normal SPAP (50.8 vs 38.5 months; P=0.008). Concerning the type of dialysis, the ratio of patients having PHT was higher in HD group compared to those on PD (18.8% vs 5.9%; p=0.008). The prevalence of chronic obstructive pulmonary artery disease, asthma, smoking, hypertension, diabetes mellitus did not differ between patients with and without PHT (P>0.05 for all). The findings of this study reveal that PHT is a common clinical condition in patients with ESRD evaluated for renal transplantation, and time being on renal replacement therapy and hemodialysis as the type of dialysis are associated with higher prevalence. Since it may be of prognostic importance in patients undergoing renal transplantation, a careful preoperative assessment including a comprehensive Doppler echocardiographic examination is needed to identify PHT.
Volume : 6
Issue : 4
Pages : 109
Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Ankara, Turkey