Prevalence and factors associated with pulmonary arterial hypertension on maintenance hemodialysis patients in Kinshasa, Democratic Republic of Congo: a cross-sectional study

Autor: François B. Lepira, Nazaire M. Nseka, Justine B. Bukabau, Evariste Mukendi Kadima, Augustin Luzayadio Longo, Vieux M. Mokoli, Cedric Kabemba Ilunga, Ernest Kiswaya Sumaili, Aliocha Nkodila, Trésor Mvunzi, Marie-France Ingole Mboliasa, Yannick Mompango Engole, Yves Simbi Lubenga, J.R. Makulo, Yannick Mayamba Nlandu
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BMC Nephrology, Vol 21, Iss 1, Pp 1-8 (2020)
BMC Nephrology
ISSN: 1471-2369
DOI: 10.1186/s12882-020-02131-x
Popis: Background Although cardiovascular diseases in particular Pulmonary Arterial Hypertension (PAH) is associated with, high morbid-mortality in chronic hemodialysis, but its magnitude remains paradoxically unknown in sub-Saharan Africa. The aim of this study was to evaluate the prevalence of PAH and associated factors in chronic hemodialysis in Sub-Saharan African population. Method In a cross-sectional study, patients treated with HD for at least 6 months in 4 hemodialysis centers were examined. PAH was defined as estimated systolic pulmonary arterial pressure (sPAP) ≥ 35 mmHg using transthoracic Doppler echocardiography performed 24 h after the HD session. Results Eighty-five HD patients were included; their average age was 52.6 ± 15.9 years. Fifty-seven patients (67.1%) were male. Mean duration of HD was 13.3 ± 11 months. With reference to vascular access, 12 (14.1%), 29 (34.1%) and 44 (51.8%) patients had AVF, tunneled cuff and temporary catheter, respectively. The underlying cause of ESRD was diabetes in 30 patients (35.3%). The prevalence of PAH was 29.4%. Patients with PAH had more hyponatremia (11 (44%) vs 10 (16.7%), p = 0.010). In multivariate analysis, unsecured healthcare funding (aOR 4, 95% CI [1.18–6.018]), arrhythmia (aOR 3, 95% CI [1.29–7.34]), vascular access change (aOR 4, 95% CI [1.18–7.51]) and diastolic dysfunction (aOR 5, 95% CI [1.35–9.57] were independently associated with PAH. Conclusion One third of hemodialysis patients exhibit PAH, which is independently associated with low socioeconomic status (unsecured funding, vascular access change) and cardiovascular complications (arrhythmia, diastolic dysfunction).
Databáze: OpenAIRE
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