Pulmonary hypertension in chronic renal failure patients

Background/Aims: Pulmonary hypertension (PHT) has been reported to be high among end-stage renal disease (ESRD) patients. This study evaluated PHT in ESRD patients and the role of arteriovenous fistula (AVF), thromboxane B-2 (TXB2) and pro-BNP in this complication. Methods: 45 ESRD patients on regular hemodialysis (HD) (group 1) and 31 ESRD patients on conservative treatment (group 2) underwent clinical and biochemical testing. Pulmonary artery pressure (PAP) was evaluated using Doppler echocardiography. Cardiac assessment by echocardiography and AVF flow measurement by Doppler ultrasound were done. Levels of TXB2 and N-terminal pro-brain natriuretic peptide (NT-proBNP) in plasma were determined. Results: PHT was found in 44.4% in group 1 and in 32.3% in group 2. Comparing the two groups shows a significant difference with regard to PAP, proBNP, and TXB2. Patients with PHT have a significantly higher AVF blood flow, proBNP, and TXB 2. In patients with PHT, 76.7% have left ventricular diastolic dysfunction (LVDD). PAP correlates with AVF flow, proBNP, and TXB2. Conclusions: Results show a high prevalence of PHT among patients with ESRD on chronic HD or on conservative treatment. PHT in such patients is related to AVF flow, TXB2 and NT-proBNP level and LVDD. AVF flow is an important correctable cause of PHT. Copyright (C) 2008 S. Karger AG, Basel.