Burden of Pulmonary Hypertension in End-Stage Renal Disease Patients Receiving Maintenance Hemodialysis: Evaluation Factors and Treatment Strategies.

Autor:	Gurusamy K; Nephrology, Tirunelveli Medical College and Hospital, Tirunelveli, IND., V R; Nephrology, Tirunelveli Medical College and Hospital, Tirunelveli, IND., P S; Nephrology, Tirunelveli Medical College and Hospital, Tirunelveli, IND., Velu KB; Nephrology, Tirunelveli Medical College and Hospital, Tirunelveli, IND., Pk S; Nephrology, Tirunelveli Medical College and Hospital, Tirunelveli, IND., Anand M; Nephrology, Tirunelveli Medical College and Hospital, Tirunelveli, IND., Daya A P; Community and Family Medicine, All India Institutes of Medical Sciences, Madurai, Madurai, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 10; Vol. 16 (9), pp. e69123. Date of Electronic Publication: 2024 Sep 10 (Print Publication: 2024).
DOI:	10.7759/cureus.69123
Abstrakt:	Background Chronic kidney disease (CKD) is an emerging public health problem in India. Pulmonary hypertension (PH) is an overlooked cardiovascular complication of CKD. This study aimed to estimate the burden of PH among CKD patients undergoing hemodialysis in a selected tertiary care hospital. In addition, it aimed to determine the various factors associated with PH and response to various treatment modalities. Methodology This hospital-based, analytical, cross-sectional study was conducted in the nephrology department of a medical college hospital in Tamil Nadu from March 2023 to March 2024. The study included 150 adults diagnosed with stage 5 CKD and registered for hemodialysis. Results Of the 150 participants, 96 (64%) had PH. Of these, 81 (84%) were males and 15 (16%) were females. In the PH group, 58 (60.4%) had type 2 diabetes mellitus, 52 (54%) had been on dialysis for 6-12 months, 67 (69.8%) had chronic glomerulonephritis, 25 (26.04%) had chronic tubular interstitial nephritis, and 72 (75%) had microcytic anemia. PH patients had significantly higher rates of protein-energy malnutrition (26 (48.2%) vs. 67 (80.7%), p < 0.009) and more frequent hospitalizations (19 (35%) vs. 69 (71.9%)) compared to those without PH. Additionally, PH patients exhibited higher incidences of left ventricular hypertrophy (72% vs. 92%), pericardial effusion (0% vs. 65%), and tricuspid regurgitation (16% vs. 100%). Patients treated with a combination of isosorbide dinitrate (ISDN) and hydralazine; extended hemodialysis; and ISDN, hydralazine, and sildenafil showed significant improvement compared to other treatment modalities. Conclusions The high prevalence of PH among CKD patients undergoing hemodialysis underscores the importance of vigilant monitoring and targeted interventions. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Tirunelveli Medical College Institutional Research Ethics Committee issued approval 20232692. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Gurusamy et al.)
Databáze:	MEDLINE
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