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Abstract：
Introduction Pulmonary hypertension (PH) is a recognized complication in patients with end-stage renal disease (ESRD undergoing maintenance hemodialysis (MHD). PH is commonly found in patients with chronic kidney disease (CKD) and ESRD. PH is associated with increased morbidity and mortality in patients with CKD. Methodology This cross-sectional study aimed to assess the prevalence of PH and its associated risk factors in MHD patients. A total of 220 ESRD patients on MHD patients at The Kidney Center, Karachi, Pakistan, aged 18-70 were included. Patients with chronic obstructive lung disease, valvular heart disease, and obstructive sleep apnea were excluded, as these conditions can be responsible for PH. PH was evaluated by echocardiography (ECHO), which was performed by a cardiologist. Results The mean age was 50.65 ± 14.4 years, with 131 (59.5%) males and 89 (40.5%) females. The average duration on hemodialysis was 5.3 ± 2.8 years. Hypertension (89.5%) and ischemic heart disease (24.1%) were prominent comorbidities. Hypertensive nephropathy (42.7%) was the leading cause of ESRD. Left ventricular hypertrophy was mild in most cases (85.5%), whereas regional wall motion abnormality (RWMA) was common (67.3%). The average pulmonary artery pressure was 35.2 ± 15.3 mmHg. Out of 220 patients, 109 patients (49.8%) of them had mild PH, nine patients (4.1%) had severe PH, and 72 patients (32.7%) had moderate PH. Associations between PH and various factors were examined. RWMA, left ventricular hypertrophy, and left ventricular ejection fraction were significantly associated with PH (p < 0.001). Serum calcium and albumin levels were also associated with PH severity (p < 0.05). Other demographic and laboratory parameters did not show a significant association. Conclusion This study highlights the prevalence of PH in MHD patients and identifies associated risk factors. Understanding these associations can aid in better managing PH in ESRD patients.
摘要：
简介肺动脉高压（PH）是终末期肾病（接受维持性血液透析（MHD）的ESRD）患者的公认并发症。PH常见于慢性肾脏病(CKD)和ESRD患者。PH与CKD患者的发病率和死亡率增加有关。方法本横断面研究旨在评估MHD患者中PH的患病率及其相关危险因素。肾脏中心共有220名接受MHD的ESRD患者，卡拉奇,巴基斯坦,包括18-70岁。慢性阻塞性肺疾病患者，心脏瓣膜病,排除阻塞性睡眠呼吸暂停，因为这些条件可能是PH的原因。通过超声心动图（ECHO）评估PH，这是由心脏病专家完成的。结果患者平均年龄50.65±14.4岁,男性131人(59.5%)，女性89人(40.5%)。血液透析的平均持续时间为5.3±2.8年。高血压（89.5％）和缺血性心脏病（24.1％）是突出的合并症。高血压肾病(42.7%)是导致ESRD的主要原因。大多数情况下左心室肥厚轻度（85.5％），而区域性壁运动异常（RWMA）是常见的（67.3％）。平均肺动脉压为35.2±15.3mmHg。在220名患者中，109例患者（49.8%）有轻度PH，9例患者（4.1%）有严重的PH，72例患者（32.7%）有中度PH。检查了PH与各种因素之间的关联。RWMA,左心室肥厚,左心室射血分数与PH显著相关(p<0.001)。血清钙和白蛋白水平也与PH严重程度相关(p<0.05)。其他人口统计学和实验室参数未显示出显着关联。结论本研究强调了MHD患者中PH的患病率，并确定了相关的危险因素。了解这些关联有助于更好地管理ESRD患者的PH。
