Prevalence of Pulmonary Hypertension in Chronic Kidney Disease.

UNLABELLED

Pulmonary hypertension is a common comorbidity in patients with chronic kidney disease and end-stage renal disease(CKD). The presence of pulmonary hypertension is associated with increased risk of hospitalization and mortality in patients with CKD. Review of literature showed that in one study, pulmonary hypertension was found in 40% of patients with end stage renal disease on chronic hemodialysis therapy via arteriovenous access. The presence of CKD was associated with 1.4-fold increased risk of having pulmonary hypertension after adjusting for other independent risk factors for CKD. Preventing pulmonary hypertension in this population is crucial because even kidney transplantation may not reverse the high mortality associated with established pulmonary hypertension.

MATERIAL

Place of study- Rajendra Institute of Medical Sciences, Ranchi. Design of study- Observational and prospective single centered study. Duration of study-18 months. Sample size-100 CKD patients admitted to department of medicine, RIMS, Ranchi. Study population-100 CKD patients meeting our inclusion criteria, admitted in the department of medicine, Rajendra Institute of Medical Sciences, Ranchi, between 1st January 2020 and 30th June 2021.

INCLUSION CRITERIA

Renal function was determined by estimated glomerular filtration rate. Only patients with stage 3 or worse CKD were included.

EXCLUSION CRITERIA

1. Those patients having stage 2 or less kidney disease were excluded. 2. Patients with congenital heart disease, chronic thromboembolic disease, acute myocardial infarction and previous lung disease or cardiac transplantation were excluded. Data was collected by oral questionnaire, relevant investigations and by doing 2D- ECHO and data was analyzed by using IBM SPSS Statistics software.

OBSERVATION

Prevalence of pulmonary hypertension in the study group was 16%. Prevalence of pulmonary hypertension was more in stage 5 CKD patients (26.19%) and the difference in prevalence of pulmonary hypertension in different stages of CKD was statistically significant(p value-0.008). Prevalence of pulmonary hypertension was more in patients on hemodialysis (27.78%) compared to those not on hemodialysis (9.37%). Pulmonary hypertension was present in 13.85% males and 20% of females, there was no statistically significant difference (p value-.428). No significant difference was found in prevalence of pulmonary hypertension between diabetic and non- diabetic patients and hypertensive and normotensive patients.

CONCLUSION

Prevalence of pulmonary hypertension was more in stage 5 CKD patients and patients on hemodialysis. There was positive correlation between high serum creatinine, high serum phosphorus, lower hemoglobin, lower serum calcium and pulmonary hypertension in CKD patients. There was no significant difference in prevalence of pulmonary hypertension in male and female patients.