Gaur Jyoti, Singh Rakesh Kumar, Kulkarni Chaitanya, Dube Simmi
Department of Medicine, Gandhi Medical College and HH, Bhopal, Madhya Pradesh, India.
Department of Cardiology, Gandhi Medical College and HH, Bhopal, Madhya Pradesh, India.
Heart Views. 2023 Jan-Mar;24(1):24-28. doi: 10.4103/heartviews.heartviews_31_22. Epub 2023 Feb 23.
The incidence of chronic kidney disease (CKD) is increasing globally and is associated with significant morbidity and mortality related to the cardiovascular system. There is limited data on pulmonary hypertension (PH) in CKD patients, especially from developing and underdeveloped countries. PH leads to hypoxia which is a significant cause of dyspnea in CKD patients with or without pulmonary edema. Hence, we planned this study to assess the PH in CKD patients using (2D) color Doppler echocardiography.
This is an observational cross-sectional study. A total of 100 CKD patients on hemodialysis or conservative management were enrolled in the study. Following the collection of demographic data, and routine/specific investigations, these patients were assessed for PH using 2D color Doppler echocardiography.
PH was found in 47% of patients with CKD. Left ventricular (LV) hypertrophy, systolic and diastolic dysfunction, dilated ventricular and left atrial/LV chambers, and valvular hypertrophy were other echocardiography findings recorded in these patients. Low hemoglobin levels, high urea/creatinine levels, and duration of hemodialysis in CKD patients were found to be significantly associated with the presence of PH.
The majority of CKD patients have PH at various stages of disease-causing unexplained dyspnea in these patients. PH is common in end-stage CKD as compared to patients with a less severe stage of CKD. Hence, CKD patients should be evaluated for PH, especially in the presence of intractable dyspnea.
慢性肾脏病（CKD）的发病率在全球范围内呈上升趋势，并且与心血管系统相关的显著发病率和死亡率有关。关于CKD患者肺动脉高压（PH）的数据有限，特别是来自发展中国家和不发达国家的数据。PH会导致缺氧，这是有或无肺水肿的CKD患者呼吸困难的一个重要原因。因此，我们计划开展这项研究，使用二维（2D）彩色多普勒超声心动图评估CKD患者的PH情况。
这是一项观察性横断面研究。共有100例接受血液透析或保守治疗的CKD患者纳入本研究。在收集人口统计学数据以及进行常规/特殊检查后，使用二维彩色多普勒超声心动图对这些患者进行PH评估。
在47%的CKD患者中发现有PH。这些患者的其他超声心动图检查结果还包括左心室（LV）肥厚、收缩和舒张功能障碍、心室和左心房/LV腔扩张以及瓣膜肥厚。发现CKD患者血红蛋白水平低、尿素/肌酐水平高以及血液透析时间与PH的存在显著相关。
大多数CKD患者在疾病的各个阶段都有PH，导致这些患者出现无法解释的呼吸困难。与CKD较轻阶段的患者相比，PH在终末期CKD中更为常见。因此，CKD患者应评估是否存在PH，特别是在存在顽固性呼吸困难的情况下。
