Suresh H, Arun B S, Moger V, Vijayalaxmi P B, Murali Mohan K T K
Department of Cardiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
Department of General Medicine, MVJ Medical College, Bengaluru, Karnataka, India.
Indian J Nephrol. 2018 Mar-Apr;28(2):127-134. doi: 10.4103/ijn.IJN_36_17.
Pulmonary hypertension (PH) is a recently recognized complication of chronic kidney disease (CKD), especially in end-stage renal disease. It has prevalence estimates of 30%-50% and is an independent predictor of increased mortality in CKD patients. The aim of this study is to analyze the prevalence of PH in patients with CKD, its severity in different stages of CKD, and risk factors for it. One hundred and eight patients with CKD treated at Karnataka Institute of Medical Sciences, Hubli, Karnataka, between January 1, 2014, and June 30, 2015, were selected. Clinical evaluation and relevant investigations including echocardiography were done. Follow-up echocardiography was done at 3 and 6 months and assessed. The mean age of studied population was 43.53 ± 14.63 years. Sex ratio was 2.72:1 (male:female). PH was present in 47 of 108 (43.5%) cases at beginning, 41 of 83 (491.4%) at 3 months, and 32 of 64 (50%) at 6 months. The prevalence and severity of PH increased with progression of CKD stage, although not statistically significant. Heart failure with reduced ejection fraction and heart failure with preserved EF were significantly higher among PH group compared to non-PH group ( < 0.01). Mean hemoglobin in PH group was significantly lower, compared to non-PH group ( < 0.01). Mean interdialytic weight gain and central venous pressure were higher among PH group than non-PH group. Higher calcium phosphate product ≥50 was more prevalent in PH group than in non-PH group. The majority of them had moderate PH at the beginning of the study which remained same, despite being on hemodialysis. PH is a common complication in CKD patients with prevalence of 43.5%-50%. Left-sided heart failure, anemia, fluid retention, and increased calcium phosphate product are the risk factors for developing PH.
肺动脉高压（PH）是慢性肾脏病（CKD）最近才被认识到的一种并发症，尤其是在终末期肾病中。其患病率估计为30%-50%，是CKD患者死亡率增加的独立预测因素。本研究的目的是分析CKD患者中PH的患病率、在CKD不同阶段的严重程度及其危险因素。选取了2014年1月1日至2015年6月30日期间在卡纳塔克邦胡布利市卡纳塔克医学科学研究所接受治疗的108例CKD患者。进行了临床评估及包括超声心动图在内的相关检查。在3个月和6个月时进行随访超声心动图检查并评估。研究人群的平均年龄为43.53±14.63岁。性别比为2.72:1（男:女）。开始时108例中有47例（43.5%）存在PH，3个月时83例中有41例（49.4%），6个月时64例中有32例（50%）。尽管无统计学意义，但PH的患病率和严重程度随CKD阶段进展而增加。与非PH组相比，PH组射血分数降低的心力衰竭和射血分数保留的心力衰竭显著更高（P<0.01）。与非PH组相比，PH组的平均血红蛋白显著更低（P<0.01）。PH组的平均透析间期体重增加和中心静脉压高于非PH组。钙磷乘积≥50在PH组比非PH组更常见。他们中的大多数在研究开始时患有中度PH，并一直保持，尽管接受了血液透析。PH是CKD患者中常见的并发症，患病率为43.5%-50%。左心衰竭、贫血、液体潴留和钙磷乘积增加是发生PH的危险因素。
