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Prognostic value of pulmonary hypertension in pre-dialysis chronic kidney disease patients

  • Nephrology - Original Paper
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Abstract

Background

Pulmonary hypertension is common in chronic kidney disease (CKD) patients. However, the prognostic value of pulmonary hypertension in Chinese predialytic CKD patients is rarely reported. We evaluated the relevant factors and prognostic value of pulmonary hypertension in CKD patients.

Methods

This retrospective cohort study enrolled 1092 predialytic patients from The Third Affiliated Hospital of Sun Yat-Sen University from May 1st, 2011, to December 31st, 2016. Data of interest were retrieved from electronic medical records. Pulmonary hypertension was defined as pulmonary arterial systolic pressure (PASP) ≥ 35 mmHg by echocardiology. All participants were followed from the date of the first echocardiography examination. The primary endpoints were all-cause mortality and cardiovascular mortality. The secondary endpoint was end-stage renal disease (ESRD) defined as starting renal replacement therapy.

Results

The prevalence of pulmonary hypertension was 15.9% in the study population. For CKD stage 1, 2, 3a, 3b, 4 and 5, the prevalence was 6.0%, 9.6%, 17.2%, 13.3%, 20.7% and 26.6%, respectively. Older age, lower left ventricular ejection fraction, anemia and higher pulse pressure were independently associated with pulmonary hypertension in CKD patients. In multivariate Cox regression analysis, pulmonary hypertension was the independent risk factor for cardiovascular mortality, but not of all-cause mortality and ESRD.

Conclusions

Pulmonary hypertension is not rare in early CKD patients. Patients with older age, anemia, higher pulse pressure and compromised heart function were more likely to comorbid pulmonary hypertension. Pulmonary hypertension maybe a sign of worse cardiovascular outcome in CKD patients.

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Author notes

  1. Xiaohao Zhang and Wenbo Zhao contributed equally to this work.

Authors and Affiliations

  1. Nephrology Division, The Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Avenue, Guangzhou, 510630, China

    Xiaohao Zhang, Wenbo Zhao, Xinxin Ma, Yuanqing Li, Hongli Shang, Jun Zhang, Zengchun Ye, Xun Liu, Tanqi Lou & Hui Peng

  2. Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Road, Guangzhou, 510120, China

    Yu Peng

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  1. Xiaohao Zhang
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Corresponding authors

Correspondence to Yu Peng or Hui Peng.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Human or animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of The Third Affiliated Hospital of Sun Yat-sen University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The ethics committee approved that informed consent could be waived due to retrospective study design.

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Cite this article

Zhang, X., Zhao, W., Ma, X. et al. Prognostic value of pulmonary hypertension in pre-dialysis chronic kidney disease patients. Int Urol Nephrol 52, 2329–2336 (2020). https://doi.org/10.1007/s11255-020-02589-6

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  • DOI: https://doi.org/10.1007/s11255-020-02589-6

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