Pulmonary Hypertension Common in Hemodialysis Patients

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Pulmonary hypertension is common in hemodialysis (HD) patients and it is associated with an increased death risk, a study found.

In a study led by Rajiv Agarwal, MD, of the Indiana University School of Medicine in Indianapolis, pulmonary hypertension was present in 110 (38%) of 288 HD patients, according to a report in Nephrology Dialysis Transplantation (published online ahead of print). Dr. Agarwal defined pulmonary hypertension as an estimated systolic pulmonary artery pressure greater than 35 mm Hg using echocardiograms performed within an hour after the end of dialysis.

Over a median follow-up period of 2.1 years, 97 patients (34%) died, for a crude mortality rate of 114.2 per 1,000 patient-years. Of these, 58 deaths occurred among the 110 patients with pulmonary hypertension and 39 occurred among subjects without pulmonary hypertension. After adjusting for multiple variables, pulmonary hypertension significantly and independently predicted a twofold increased risk of all-cause mortality.

Pulmonary hypertension was strongly associated with an enlarged left atrium.

“Reducing left atrial size such as through volume control may be an attractive target to improve pulmonary hypertension,” Dr. Agarwal concluded.

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