Subcutaneous treprostinil was effective and tolerable in a patient with severe pulmonary hypertension associated with chronic kidney disease on hemodialysis

Autor: Kohtaro Abe, Koshin Horimoto, Kazuya Hosokawa, Takanori Watanabe, Hiroyuki Tsutsui, Kisho Ohtani
Rok vydání: 2016
Předmět:
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Sildenafil
medicine.medical_treatment
Hypertension
Pulmonary
Injections
Subcutaneous
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Severity of Illness Index
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Renal Dialysis
Internal medicine
medicine
Humans
Renal Insufficiency
Chronic
Antihypertensive Agents
Cardiac catheterization
Dose-Response Relationship
Drug
business.industry
Hemodynamics
Drug Tolerance
Middle Aged
medicine.disease
Pulmonary hypertension
Epoprostenol
Bosentan
Surgery
medicine.anatomical_structure
030228 respiratory system
chemistry
Vascular resistance
Cardiology
Hemodialysis
Cardiology and Cardiovascular Medicine
business
Treprostinil
medicine.drug
Kidney disease
Zdroj: Heartlung : the journal of critical care. 46(2)
ISSN: 1527-3288
Popis: Background Pulmonary hypertension (PH) is a life-threatening complication in patients with chronic kidney disease on hemodialysis (CKD-HD). Objectives To determine whether subcutaneous infusion of treprostinil was effective and tolerable CKD-PH. Methods and results A 57-year-old man was admitted to our hospital due to presyncope and dyspnea during exercise with a history of CKD-HD. Cardiac catheterization revealed high pulmonary arterial pressure (PAP) of 53/24/32 mmHg and pulmonary vascular resistance (PVR) of 11.2 w.u. Upfront combination therapy with bosentan and sildenafil was started. However, 6-month therapy did not attenuate his symptoms, probably due to the high PAP and PVR (60/19/30 mmHg and 5.9 w.u.). We added subcutaneous treprostinil. Surprisingly, 9-month treprostinil (50 ng/kg/min) normalized hemodynamics (PAP: 25/4/13 mmHg and PVR: 1.9 w.u.). His symptoms during excise disappeared without any adverse effects. Conclusion This is the first report that subcutaneous treprostinil was very effective and tolerable in a PH patient with CKD-HD.
Databáze: OpenAIRE
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