Pulmonary Hypertension in a Group of Patients with Various Stages of Renal Disease

Background: The pathogenesis of pulmonary hypertension (PHT) associated with renal failure is complex. It includes metabolic and hormonal changes, high cardiac output due to arteriovenous fistula (AVF), anemia, and other factors. Objectives: The objective is to identify PHT frequency and associated factors in patients on hemodialysis (HD) compared to patients, not on HD. Methods: A cross-sectional study was conducted at Ibn Sena teaching hospital/Mosul and included 100 diabetic males with end-stage renal disease on HD (Group 1) compared to 96 diabetic males (of similar age) with chronic kidney disease but not on HD (Group 2) to assess the pulmonary artery pressure using Doppler echocardiogram. Patients with other causes of PHT such as heart failure and chronic lung disease were excluded from the study. Results: 42 (42%) of patients in Group 1 had PHT and 12 (12.5%) patients in Group 2. There were statistically significant differences between patients with and without PHT regarding ejection fraction (EF), but no significant differences regarding age, duration of dialysis, hemoglobin (Hb), and vascular access type in both groups. Conclusions: EF had a relationship with PHT, whereas the duration of dialysis, age of patients, Hb, and dialysis access type had no relationship to PHT. Recommendations: More studies are needed in our country regarding PHT in patients with variable stages of renal disease with larger sample sizes and different designs with the inclusion of data and parameters that were missing in our study such as duration of AVF creation.