Subject(s)
Cryoglobulinemia/pathology , Glomerulonephritis/pathology , Nephrotic Syndrome/pathology , Purpura/etiology , Cryoglobulinemia/complications , Cryoglobulinemia/therapy , Glomerulonephritis/complications , Glomerulonephritis/therapy , Humans , Male , Middle Aged , Nephrotic Syndrome/complications , Nephrotic Syndrome/therapyABSTRACT
The aim of this study was to evaluate the prevalence of primary pulmonary hypertension (PHT) among hemodialysis patients and search for possible etiologic factors. The prevalence of PHT was prospectively estimated by Doppler echocardiogram in 62 long-term hemodialysis patients on the day post dialysis. PHT (> 35 mm Hg) was found in 32 (51.6%) patients with a mean systolic pulmonary artery pressure of 39.6 +/- 13.3 mmHg. The hemoglobin and albumin levels were significantly lower in the PHT subgroup (11.1 +/- 1.86 vs 9.8 +/- 1.97 g/dL and 3.75 +/- 0.44 vs 3.38 +/- 0.32 g/dL, p = 0.01 and 0.02, respectively). Our study demonstrates a surprisingly high prevalence of PHT among patients receiving long-term hemodialysis. Early detection is important in order to avoid the serious consequences of the disease.
Subject(s)
Hypertension, Pulmonary/epidemiology , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Renal Dialysis/adverse effects , Adult , Aged , Calcium/blood , Female , Humans , Male , Middle Aged , Parathyroid Hormone/blood , Phosphates/blood , Serum Albumin/metabolismABSTRACT
INTRODUCTION: The aim of this study was to evaluate the frequency of unexplained pulmonary hypertension (PHT) among patients on hemodialysis at 2 centers and to evaluate possible predisposing factors. MATERIALS AND METHODS: In this cross-sectional study, PHT was screened by Doppler echocardiography on the day after dialysis in 62 patients with end-stage renal disease receiving maintenance hemodialysis via arteriovenous access. Pulmonary hypertension was defined as a systolic pulmonary arterial pressure (PAP) higher than 35 mm Hg, and the systolic PAP was calculated using the modified Bernoulli equation. Clinical variables were compared between patients with and without PHT. RESULTS: A PAP higher than 35 mm Hg was found in 32 patients (49.3%) receiving hemodialysis, with a mean systolic PAP of 39.58 +/- 13.27 mm Hg. Blood hemoglobin level was significantly lower in the patients with PHT than those without PHT (9.8 +/- 1.97 g/dL versus 11.07 +/- 1.86 g/dL; P = .01). In addition, serum levels of albumin was lower in these patients (3.38 +/- 0.32 g/dL versus 3.75 +/- 0.44 g/dL; P = .02). CONCLUSIONS: This study demonstrates a surprisingly high prevalence of PHT among patients with end-stage renal disease receiving hemodialysis. We concluded that the best approach to this unrecognized complication that is associated with reduced survival is keeping it in mind and looking for it in the management of patients on dialysis.
