Pulmonary hypertension in chronic renal failure patients.
OBJECTIVE
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) (TXB(2)) 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 TXB(2) 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 TXB(2). 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 TXB(2).


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, TXB(2) and NT-proBNP level and LVDD. AVF flow is an important correctable cause of PHT.
Abdelwhab
Saeed
S
Faculty of Medicine, Ain Shams University, Cairo, Egypt. profsaeed11@gmail.com
Elshinnawy
Samah
S
D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000378:metabolism; D001794:Blood Pressure; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000494:pharmacology; D011863:Radioimmunoassay / Q000379:methods; D013929:Thromboxane B2 / Q000378:metabolism
D020097:Natriuretic Peptide, Brain; D013929:Thromboxane B2