title: Frequency of pulmonary hypertension in hemodialysis patients.
abstract: OBJECTIVE
  Pulmonary hypertension (PH) has been described in hemodialysis (HD) patients and has been associated with increased morbidity and mortality. Our objective was to determine the prevalence of pulmonary hypertension in patients on regular hemodialysis.
  
  
  METHODS
  This cross sectional study was conducted in Department of Nephrology, Liaquat National Hospital Karachi from April 2013 to March 2014. Eighty patients of end stage renal disease (ESRD), on maintenance hemodialysis (HD); underwent Trans thoracic Echocardiography were selected. Systolic pulmonary arterial pressure (SPAP) was recorded. Pulmonary hypertension was defined as, pulmonary artery pressure (PAP) greater than 30 mm Hg at rest. Pulmonary hypertension was further divided into mild (PAP b/w 30-45mmHg), moderate (PAP b/w 45-65mmHg) and severe pulmonary hypertension (PAP > 65mmHg). The effect of different vascular accesses, age, gender, dialysis vintage on the development of pulmonary hypertension was observed.
  
  
  RESULTS
  Out of 80 patients, 45 patients (56%) had pulmonary hypertension (PH); 25(55.5%) had moderate, 13(29%) had mild, and 7 (15.5%) patients had severe pulmonary hypertension (PH). Pulmonary hypertension was present in 41(60%) patients with AVF, 3(27%) patients with tunnel cuffed catheter and 1 patient had AV bridge graft. Pulmonary hypertension was more common in females; present in 28 females (67%) and 17 males (45%), that was statistically significant (p<0.05). Mean duration of hemodialysis in (months) of patients with PH was 20.93 ± 12 vs. 10.29 ±10 in patients without PH (p<0.05). Age had no relation to development of PH.
  
  
  CONCLUSIONS
  ESRD patients on HD have strong tendency to develop PH. Our study demonstrated that PH is more common among females. Duration of hemodialysis and AV access has strong relation to the development of PH.
authors: Dr. Kunwer Naveed Mukhtar, MD, DABN, Associate Professor, Head Department of Nephrology & Transplantation, Liaquat National Hospital & Medical College, Karachi, Pakistan.
authors: Kunwer Naveed
authors: KN
authors: Mukhtar
authors: Dr. Syed Mohkumuddin, MBBS, FCPS, Consultant Nephrologist, Department of Nephrology, Sandamen Provincial Hospital Quetta, Pakistan.
authors: Syed
authors: S
authors: Mohkumuddin
authors: Dr. Sumbal Nasir Mahmood, MD, DABN, Associate Professor, Department of Nephrology, Dr. Ziauddin Hospital & Medical College, Karachi, Pakistan.
authors: Sumbal Nasir
authors: SN
authors: Mahmood
keywords: CKD = Chronic kidney disease; ESRD = End stage renal disease; HD = Hemodialysis; PAP = Pulmonary artery pressure; PH = Pulmonary hypertension; SPAP = Systolic pulmonary arterial pressure