Pulmonary hypertension: An emerging problem in patients undergoing regular hemodialysis

in patients undergoing regular hemodialysis [HD] due to end-stage renal disease [ESRD]

Study Design: Cross-sectional analytical study

Place and Duration of Study: Nephrology Department, Lahore General Hospital, Pakistan, from July to December 2016

Methodology: Fifty patients with end-stage renal disease. Various parameters, including the pulmonary arterial systolic pressure [PASP], were recorded. Pulmonary arterial pressure greater than 25 mmHg at rest was defined as pulmonary hypertension. It was further divided into three sub categories as mild [25-40 mmHg], moderate [40-55 mmHg], and severe [greater than 55 mmHg]. Data were correlated with age, gender, body mass index, systemic hypertension, diabetes, duration of dialysis, and Hb [hemoglobin] concentration. Data was analysed using SPSS version 23.0

Results: The median [IQR] duration of dialysis was 12 [11.25] months. Eighteen [36%] patients were found to have PH.It is greater in patients who had been on dialysis for more than 5 months. A positive association was seen between the duration of dialysis and the prevalence of PH [p=0.024]

Conclusion: A considerable number of patients on hemodialysis have pulmonary hypertension which is associated with the longer duration of maintenance hemodialysis

Frequency of restrictive pulmonary dysfunction in type-1 and type-2 diabetes mellitus

Objective: to determine the frequency of restrictive pulmonary dysfunction in type 1 and type 2 diabetic patients and to measure the severity of pulmonary dysfunction

Material and Methods: this study included 255 patients of type I and type II diabetes who had followed up in the out patient departments of Pulmonology and Medicine in Mayo Hospital, Lahore. Forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1] were measured using standard spirometry

Results: mean age was 47.26+/-19.076 years. 230 [90.2%] were males and 25 [9.8%] were females. 58 [22.7%] were type 1 diabetics and 197 [77.3%] were type 2 diabetics. 37 [14.5%] had restrictive pathology, 6 [2.4%] had obstructive pathology and 212 [83.1%] had normal lung function tests. 35 [13.7%] had mild restrictive dysfunction and 2 [0.8%] had moderate restrictive lung dysfunction

Conclusion: These data support the notion that the lung is a target organ for diabetic injury. Additional research is required to identify pathophysiologic mechanisms and to determine clinical significance