Pulmonary hypertension in dialysis patients


E.O. Borodulina, S.A. Karpunin, A.M. Shutov

1Kirov Regional Clinical Hospital, Healthcare Educational Institution "Nephrology Advisory Council" 2 Ulyanovsk State University, School of Medicine
Purpose. The aim of this study was to evaluate the dynamics of pulmonary artery pressure within a year of hemodialysis treatment and investigate the relationship between blood flow in arteriovenous fistula and pulmonary artery pressure.
Material and methods. 50 dialysis patients (19 males and 31 females) were evaluated. At the beginning of dialysis 42 patients had arterial hypertension and 32 patients – chronic heart failure. At the beginning of dialysis and after a year follow up in all patients cardiac functions were evaluated by echocardiography and arteriovenous fistula flow (AVF) was measured by Doppler sonography. Pulmonary hypertension was diagnosed according to criteria of Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology.
Results. Pulmonary hypertension was found in 29 (58%) patients. Before the beginning of dialysis correlation was detected between systolic PAP and LVMMI (r=0.56; P=0.008), left ventricular ejection fraction (r=-0.54; P<0.001), hemoglobin (r=-0.37; P=0.01) and LV isovolumic relaxation time (IVRT: r=0.79; P<0.001).
At the end of the follow-up left ventricular myocardial mass decreased from159.1±35.8 to 129.1±42.2 g/m2 (Р=0.04), systolic PAP decreased from 46.3±16.1 to 40.4±11.7 mm Hg (Р=0.01). No correlation was found between PAP and arteriovenous fistula flow (r=0.11; P=0.3).
Conclusion. Pulmonary hypertension was observed in half of the patients at the beginning of HD and was associated with left ventricular hypertrophy, systolic and diastolic left ventricular dysfunction. A year later a partial regression of LVH and decrease the severity of pulmonary hypertension were found. There was no correlation between arteriovenous fistula flow and pulmonary artery pressure.

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About the Autors


Author Information:
E.O. Borodulina - Nephrologist of Department of Hemodialysis of Kirov Regional Clinical Hospital, Healthcare Educational Institution "Nephrology Advisory Council"
S.A. Karpunin - Head of Department of Hemodialysis of Kirov Regional Clinical Hospital, Healthcare Educational Institution "Nephrology Advisory Council"
A.M. Shutov – Ph.D., Prof. Head of Department of Internal Medicine and Occupational Diseases, School of Medicine of Ulyanovsk State University
Е-mail: amshu@mail.ru


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