title: Pulmonary hypertension in patients with stage 1-3 chronic kidney disease.
abstract: Pulmonary hypertension (PH) secondary to chronic kidney disease (CKD) is common, but in stages 1-3 CKD patients, it remains unclear. We sought to evaluate the prevalence of PH and elucidate the possible pathogenesis in Chinese patients with early stage kidney disease. Doppler-estimated pulmonary systolic artery pressure (PASP) was measured in 101 CKD patients with glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m(2) and 27 CKD patients with GFR < 60 mL/min/1.73 m(2). Echocardiographic parameters, plasma brain natriuretic peptide (BNP), and baseline characteristics of patients were recorded. PH was defined as a PASP ≥ 35 mmHg. PH prevalence was 23.76% (24/101) in GFR ≥ 60 mL/min/1.73 m(2) group and 48.15% (13/27) in GFR < 60 mL/min/1.73 m(2) group, P < 0.05. Mean lnBNP was 4.93 ± 1.60 pg/mL in 37 cases with PH and 2.89 ± 1.29 pg/mL in those without, P < 0.01. Left atrial diameter (LA) showed deviation between patients with (43.94 ± 5.81 mm) and without PH (37.76 ± 7.48 mm), P < 0.01. GFR declined significantly in PH group (44.10 ± 22.90 mL/min/1.73 m(2)) compared to non-PH group (75.59 ± 31.62 mL/min/1.73 m(2)), P < 0.01. lnBNP, LA and GFR were independent determinants (r = 0.651, 0.595, -0.488, P < 0.01) of PASP. PH is prevalent among stage 1-3 CKD patients in China. Doppler-estimated PASP is strongly associated with lnBNP, enlarged LA and GFR. Monitoring PASP, plasma BNP and evaluation renal function may help to detect and prevent severe PH in CKD.
authors.affiliation: Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, China.
authors.forename: Q M
authors.initials: QM
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, China XiaorongBAOcn@163.com.
authors.forename: X R
authors.initials: XR
authors.lastname: Bao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D012307:Risk Factors; D055815:Young Adult