Study on the changes in pulmonary artery pressure in elderly Chronic kindney disease patients without end-stage renal disease / 中华老年医学杂志

ABSTRACT

Objective To prospectively investigate the characteristics and correlative influential factors for the changes in pulmonary artery hypertension (PAH)in chronic kidney disease (CKD) patients without end-stage renal disease.Methods Complete clinical and laboratory data of 133 outpatients without ESRD (CKD stage 2,3 and 4)in Beijing Hospital between January 2012 and January 2013 were retrospectively analyzed.Pulmonary artery systolic pressure(PASP)was assessed by echocardiography according to the guideline from the American Society of Echocardiography in 2010,and PASP more than 35 mmHg(1 mmHg=0.133 kPa)was diagnosed as PAH.Results PAH was found in twelve(9.0 ％) patients,including 7 females and 5 males,with mean age(82.9 ± 5.4 years).The prevalence of PAH was 2.3％,10.9％ and 17.6％ in the patients of CKD stage 2,3 and 4(P＜ 0.05) respectively.PASP could be calculated in 67 patients in whom tricuspid regurgitation was present.The mean PASP was (27.1 ± 5.4) mmHg,(31.0 ± 8.3) mmHg and (37.3 ± 13.8) mmHg in patients with CKD stage 2,3 and 4,respectively(P ＜ 0.05).Body mass index(BMI),eGFR and BUN showed significant differences between PAH group and non-PAH group with statistical significance (P＜0.05).Multivariate logistic regression analysis revealed that the lower BMI and the higher stage of CKD were independent risk factors for PAH (P ＜ 0.05).Conclusions PAH is not a rare complication in the CKD patients without end-stage renal disease.The incidence of PAH is significantly associated with lower BMI and the higher stage of CKD.Doppler echocardiography should be performed periodically to detect PAH in CKD patients in order to improve the prognosis of these patients.