Background: recent studies have shown a high incidence of unexplained pulmonary hypertension (PHT) in end-stage renal disease (ESRD) patients with or without haemodialysis (HD) therapy. The aim of this study was to evaluate the prevalence of unexplained PHT among patients with ESRD on regular HD and possible role of arteriovenous (AV) shunt as an etiological factor.
Materials and methods: We enrolled 80 consecutive patients with ESRD on regular HD via AV shunt. Forty random chronic kidney disease (CKD) (predialysis) patients were taken up as a control. All patients underwent transthoracic echocardiography to assess the pulmonary artery pressure and cardiac output (CO). Pulmonary hypertension was defined as, pulmonary artery systolic pressure (PASP) greater than 35 mm Hg at rest. In HD patients with PHT, we reassessed CO and PASP before and after 1 minute of temporary compression over the AV shunt.
Results: Patients on HD had higher PASP in comparison to control group. Out of 80 HD patients studied, 16 patients (20%) had PHT (PASP = 46±2 mmHg) while the rest had a normal PASP (29±1 mmHg) (P