title: Pulmonary hypertension in CKD.
abstract: Pulmonary arterial hypertension is a rare disease often associated with positive antinuclear antibody and high mortality. Pulmonary hypertension, which rarely is severe, occurs frequently in patients with chronic kidney disease (CKD). The prevalence of pulmonary hypertension ranges from 9%-39% in individuals with stage 5 CKD, 18.8%-68.8% in hemodialysis patients, and 0%-42% in patients on peritoneal dialysis therapy. No epidemiologic data are available yet for earlier stages of CKD. Pulmonary hypertension in patients with CKD may be induced and/or aggravated by left ventricular disorders and risk factors typical of CKD, including volume overload, an arteriovenous fistula, sleep-disordered breathing, exposure to dialysis membranes, endothelial dysfunction, vascular calcification and stiffening, and severe anemia. No specific intervention trial aimed at reducing pulmonary hypertension in patients with CKD has been performed to date. Correcting volume overload and treating left ventricular disorders are factors of paramount importance for relieving pulmonary hypertension in patients with CKD. Preventing pulmonary hypertension in this population is crucial because even kidney transplantation may not reverse the high mortality associated with established pulmonary hypertension.
authors.affiliation: Nephrology, Dialysis and Transplantation Unit, Reggio Calabria, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Bolignano
authors.forename: Stefania
authors.initials: S
authors.lastname: Rastelli
authors.forename: Rajiv
authors.initials: R
authors.lastname: Agarwal
authors.forename: Danilo
authors.initials: D
authors.lastname: Fliser
authors.forename: Ziad
authors.initials: Z
authors.lastname: Massy
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiecek
authors.forename: Alberto
authors.initials: A
authors.lastname: Martinez-Castelao
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: David
authors.initials: D
authors.lastname: Goldsmith
authors.forename: Gultekin
authors.initials: G
authors.lastname: Suleymanlar
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Rosa
authors.initials: R
authors.lastname: Sicari
authors.forename: Luna
authors.initials: L
authors.lastname: Gargani
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
authors.forename: Gerard
authors.initials: G
authors.lastname: London
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
mesh_terms: D001164:Arteriovenous Fistula / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D008567:Membranes, Artificial; D015995:Prevalence; D011651:Pulmonary Artery / Q000002:abnormalities / Q000503:physiopathology; D011667:Pulmonary Veins / Q000002:abnormalities / Q000503:physiopathology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000453:epidemiology
chemical_list: D008567:Membranes, Artificial