Русский
Features of development and clinical picture of pulmonary hypertension in patients with chronic kidney disease
K.Sh. Dzheyentaev, R.R. Kaliyev
Aim. to determine the features of development and clinical picture of pulmonary hypertension (PH) in patients with chronic kidney disease (CKD).
Material and methods. 60 patients aged 18 to 70 years with a diagnosis of CKD III–V stages underwent examination. Depending on the presence of PH and the stage of the disease, the patients were divided into 4 groups: Group 1–20 patients with CKD V stage and PH receiving HD; Group 2–20 patients with CKD V stage and without PH who received HD; Group 3–15 patients with CKD III–V stages and without PH; Group 4–5 patients with CKD III–V stages and PH.
Results. PH developed at the pre-dialysis stage of CKD at a young age (35.4±16.18 years). Patients with PH complained of dyspnea (P1–2= 0.052), edema (P1–2=0.058). With physical examination, increase in systolic BP (P1– 2=0.009, P2–4= 0.004, P3–4= 0.02) and diastolic BP (Р2–4=0.02), right heart enlargement (Р1–2=0.016; Р3–4=0.053) and hepatomegaly (Р1–2=0.0098) were revealed. Radiologically, patients with PH had pleural effusions (P1–2=0.053), signs of venous stasis in the lungs (P1–2=0.053), and cardiomegaly (P2–4=0.017; P3–4=0.047). With spirometry, in patients with PH a decrease in the basic parameters of respiratory function of the lungs were documented. On ECG and EchoCG in patients with PH, left ventricle (LV) hypertrophy (P3–4=0.03), an increased left atrium and right ventricle indices (P1–2=0.0014, P1–3=0.007, P1–3=0.03), reduced ejection fraction (P1–2=0.007, P2–4=0.002), increased LV myocardial mass (P1–3=0.008), and hydropericardium (P1–2=0.004, P3–4=0.005) were detected.
Conclusion. Reduction in renal function led to pathological changes in the lungs and heart with the formation of PH. The risk factors for PH in patients with CKD include violations of excretion of body fluids and hyperhydration.
Material and methods. 60 patients aged 18 to 70 years with a diagnosis of CKD III–V stages underwent examination. Depending on the presence of PH and the stage of the disease, the patients were divided into 4 groups: Group 1–20 patients with CKD V stage and PH receiving HD; Group 2–20 patients with CKD V stage and without PH who received HD; Group 3–15 patients with CKD III–V stages and without PH; Group 4–5 patients with CKD III–V stages and PH.
Results. PH developed at the pre-dialysis stage of CKD at a young age (35.4±16.18 years). Patients with PH complained of dyspnea (P1–2= 0.052), edema (P1–2=0.058). With physical examination, increase in systolic BP (P1– 2=0.009, P2–4= 0.004, P3–4= 0.02) and diastolic BP (Р2–4=0.02), right heart enlargement (Р1–2=0.016; Р3–4=0.053) and hepatomegaly (Р1–2=0.0098) were revealed. Radiologically, patients with PH had pleural effusions (P1–2=0.053), signs of venous stasis in the lungs (P1–2=0.053), and cardiomegaly (P2–4=0.017; P3–4=0.047). With spirometry, in patients with PH a decrease in the basic parameters of respiratory function of the lungs were documented. On ECG and EchoCG in patients with PH, left ventricle (LV) hypertrophy (P3–4=0.03), an increased left atrium and right ventricle indices (P1–2=0.0014, P1–3=0.007, P1–3=0.03), reduced ejection fraction (P1–2=0.007, P2–4=0.002), increased LV myocardial mass (P1–3=0.008), and hydropericardium (P1–2=0.004, P3–4=0.005) were detected.
Conclusion. Reduction in renal function led to pathological changes in the lungs and heart with the formation of PH. The risk factors for PH in patients with CKD include violations of excretion of body fluids and hyperhydration.
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