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. 2010 Oct 5;3:279–286. doi: 10.2147/IJGM.S12946

Table 4.

Review of studies evaluating pulmonary hypertension in patients with end stage renal disease

Country of study Number of patients Mean age Male/female Incidence of PH Reason for HD Factors associated with PH Long-term outcome Notes
Abdelwhab et al3 Egypt 45 50.8 ± 8 58%/42% 44.4%
Mazdeh et al21 Iran 62 51.1 ± 17.3 18/14 52% Dm and HTN
Tarrass et al22 Morocco 86 45.4 ± 14.4 40/46 26.7% GN>>HTN Excluded COPD, collagen vascular disease, SLE, LVEF < 50%, significant valvular disease
Yigla et al2 Israel 58 40% Dm>HTN>GN High CO, lower hemoglogin, shorter duration of HF At 24–60 months follow-up, mortality was 30 versus 8.5% in patients with and without PH

  • After HD in 9 patients, PAP decreased in 3 patients, increased in 4 patients and remained same in 2 patients

  • In 4/5 HD patients, PAP normalized after renal transplantation

  • In 4 patients, CO and PAP decreased with access compression
Yigla et al23 Israel 127a No PH: 61.2 ± 13.4
PH before HD: 63.3 ± 14.0
PH after HD: 62.9 ± 17.4		 No PH: 56/34
PH before HD: 10/7
PH after HD: 12/8		 29% Dm>Pyelonephritis>
HTN>
Nephrolithiasis>
Polycystic kidney disease>GN		 1-, 3-, and 5-year mortality in patients with and without PH were 21.4% vs 3.5%, 57.1% vs 21.2%, and 74.8% vs 33.6% Predictors of mortality:

  • Univariate analysis – age at onset of HD, valvular diseases, PH prevalence before HD, PH incidence after HD

  • Multivariate analysis – development of PH before and after HD initiation
Amin et al20 Egypt 51 PH: 44 ± 10
No PH: 41 ± 11		 PH: 4/11
No PH: 24/12		 29% HTN>
Pyelonephritis = GN
>Dm		 No significant difference in Tc 99m diphosphate scintigraphy, PTH, Ca, phosphorus between PH and no PH patients – Higher incidence of PH in women
Havlucu et al14 Turkey 25 60.1 ± 15.6 40%/60% 56% HTN/GN/Dm Higher CO, longer duration of CRI, higher PTH+Ca/PO4 product, higher probability of having AVF Excluded cardiac etiology (diastolic/systolic dysfunction)
a

Note: This included patients from Yigla2.

Abbreviations: PH, pulmonary hypertension; HD, hemodialysis; Dm, diabetes mellitus; HTN, hypertension; GN, glomerulonephritis; CO, cardiac output; HF, heart failure; COPD, chronic obstructive pulmonary disease; SLE, systemic lupus erythematosus; LVEF, left ventricular ejection fraction; PAP, pulmonary artery pressure; CRI, chronic renal insufficiency; PTH, parathyroid hormone; AVF, arteriovenous fistula.