Article

Doppler echocardiograph evaluation of pulmonary hypertension in patients undergoing hemodialysis.

Department of Nephrology and Dialysis, IBN ROCHD University Hospital Center, Casablanca, Morrocco.
Hemodialysis International (impact factor: 1.54). 10/2006; 10(4):356-9. DOI:10.1111/j.1542-4758.2006.00129.x
Source: PubMed

ABSTRACT Pulmonary hypertension (PH) has been reported in hemodialysis (HD) patients, but data regarding its incidence and mechanisms are scarce. The aims of this study was to evaluate the prevalence of unexplained PH in long-term HD patients, and to examine some possible etiologic factors for its occurrence. The prevalence of PH was estimated by Doppler echocardiography in a cohort of 86 stable patients on HD via arteriovenous access for more than 12 months. All the patients underwent full clinical evaluation, chest radiography, and a standard 12-lead echocardiograph. Laboratory investigation included a mean of 12 months (serum calcium, phosphorus, parathormone (PTH), alkaline phosphatase, lipids, and hemoglobin). Pulmonary hypertension was defined as pulmonary artery systolic pressure >35 mmHg as determined by Doppler echocardiography using the modified Bernoulli equation. Pulmonary hypertension was detected in 23 patients (26.74%). Of those with PH, left ventricular hypertrophy was seen in 13 patients (56.52%), and valvular calcifications in 6 patients (26.08%). There were no significant differences between both groups with regard to age, sex, duration of dialysis, shunt location, and all the biological parameters of the study. The presence of PH was not related to the level of PTH, or the severity of other metabolic abnormalities. This study demonstrates a high prevalence of PH among patients with ESRD receiving long-term HD via surgical arteriovenous access. The role of the vascular access, anemia, or secondary hyperparathyroidism as the etiology of PH in HD patients did not hold in this study.

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Keywords

13 patients
 
alkaline phosphatase
 
arteriovenous access
 
chest radiography
 
Doppler echocardiography
 
full clinical evaluation
 
Laboratory investigation
 
long-term HD
 
long-term HD patients
 
modified Bernoulli equation
 
possible etiologic factors
 
pulmonary artery systolic pressure >35 mmHg
 
Pulmonary hypertension
 
serum calcium
 
standard 12-lead echocardiograph
 
surgical arteriovenous access
 
unexplained PH
 
valvular calcifications
 
vascular access
 
ventricular hypertrophy
 

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