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KMID : 0359920110300010048
Korean Journal of Nephrology
2011 Volume.30 No. 1 p.48 ~ p.52
Pulmonary Hypertension in End-Stage Renal Disease Patients with Maintenance Hemodialysis
Chung Chang-Su

Lee Young-Ki
Choi Jong-Su
Lee Seung-Min
Song Young-Rim
Kim Su-Jin
Park Tae-Jin
Oh Ji-Eun
Seo Jang-Won
Yoon Jong-Woo
Koo Ja-Ryong
Kim Hyung-Jik
Noh Jung-Woo
Choi Seong-Hoon
Abstract
Purpose: Pulmonary hypertension can occur from diverse etiologies. It was reported that pulmonary hypertension also complicated dialysis patents, but the exact mechanisms were not determined. The aim of this study was to evaluate the prevalence and risk factors of pulmonary hypertension in maintenance hemodialysis patients. In addition, we studied the relationship between pulmonary hypertension and arteriovenous access.

Methods: Fifty-nine chronic hemodialysis patients underwent clinical evaluation. Pulmonary artery pressure (PAP) was estimated by Doppler echocardiography. Pulmonary hypertension was defined as PAP ¡Ã35 mmHg.

Results: Mean PAP value of subjects was 39.3¡¾13.2 mmHg. Pulmonary hypertension was found in 31 (53%) of patients receiving hemodialysis (49.0¡¾10.6 mmHg; range 37 to 84 mmHg). Clinical and biochemical parameters did not differ significantly between patients with pulmonary hypertension and without pulmonary hypertension. In 19 patients, PAP was elevated from 27.8¡¾10.2 mmHg to 41.8¡¾11.9 mmHg (p<0.001) after onset of hemodialysis via arteriovenous fistula. And pulmonary hypertension developed in 12 of 15 patients with normal PAP after onset of hemodialysis treatment.

Conslusion: The prevalence of pulmonary hypertension was high, and hemodialysis via arteriovenous access may be involved in the development of pulmonary hypertension.
KEYWORD
Hypertension, Pulmonary, Hemodialysis, Arteriovenous fistula
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