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Estimation of pulmonary artery systolic pressure in hemodialysis patients and its association with cardiorespiratory fitness and pulmonary function

  • Nephrology - Original Paper
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Abstract

Purpose

To evaluate the estimated pulmonary arterial systolic pressure (PASP) through transthoracic echocardiography in hemodialysis (HD) patients and associate it with cardiorespiratory fitness and pulmonary function.

Methods

This study was a cross-sectional analysis of HD patients that performed evaluations of cardiac function, cardiorespiratory fitness, and pulmonary function, through transthoracic echocardiography, cardiopulmonary exercise test, spirometry, and manovacuometry, respectively. All patients underwent the evaluations on a non-dialysis day.

Results

Thirty-five HD patients were evaluated and separated according to the presence of probable pulmonary hypertension (PH) (estimated PASP ≥ 35 mmHg) or not (estimated PASP < 35 mmHg). Those HD patients with probable PH had the worst cardiorespiratory fitness, evaluated by the peak oxygen consumption (VO2peak) (17.11 ± 4.40 versus 12.90 ± 2.73 mL/kg/min; p = 0.011), and pulmonary function, evaluated by absolute and predicted of forced vital capacity (FVC) (85.52 ± 12.29 versus 71.38 ± 11.63%; p = 0.005) and absolute and predicted of forced expiratory volume in the first second (FEV1) (83.37 ± 14.98 versus 69.21 ± 13.48%; p = 0.017). The secondary analysis showed that estimated PASP was correlated with VO2peak (r = − 0.508; p = 0.002), FVC (r = − 0.450; p = 0.007), and FEV1 (r = − 0.361; p = 0.033). Moreover, the adjusted odds ratio by HD vintage, dry weight and gender showed that increments in VO2peak (OR 1.62; CI 95% 1.04–2.54; p = 0.034), FVC (OR 39.67; CI 95% 1.74–902.80; p = 0.021), and FEV1 (OR 39.54; CI 95% 1.89–826.99; p = 0.018) were associated with 1-fold and 39-fold higher chance, respectively, for not having PH. However, all these associations were lost when age was included in the analysis.

Conclusions

The HD patients with probable PH had the worst cardiorespiratory fitness and pulmonary function. Exploratory analyses showed that greater cardiopulmonary fitness was associated with better cardiac function. Moreover, increments in cardiorespiratory fitness and pulmonary function may increase the chance of not having PH.

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Acknowledgements

We appreciate the funding organizations Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and Hospital de Clínicas de Porto Alegre—Research Incentive Fund (FIPE).

Funding

The authors disclosed receipt of the following financial support for the publication of this article: Hospital de Clínicas de Porto Alegre—Research Incentive Fund (FIPE) [grant number 2015-0151] and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.

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Authors and Affiliations

  1. Ciências Pneumológicas Post-Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Ramiro Barcelos, 2400, 2º andar, Porto Alegre, RS, 90040-060, Brazil

    Gabrielle Costa Borba, Francini Porcher Andrade, Tatiane de Souza Ferreira & Paula Maria Eidt Rovedder

  2. Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil

    Gabrielle Costa Borba, Francini Porcher Andrade, Tatiane de Souza Ferreira, Antônio Fernando Furlan Pinotti, Francisco Veríssimo Veronese & Paula Maria Eidt Rovedder

  3. Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal

    Francini Porcher Andrade & Paula Maria Eidt Rovedder

  4. Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

    Antônio Fernando Furlan Pinotti

  5. Division of Nephrology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

    Francisco Veríssimo Veronese

  6. Physiotherapy School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

    Paula Maria Eidt Rovedder

Authors
  1. Gabrielle Costa Borba
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  2. Francini Porcher Andrade
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  3. Tatiane de Souza Ferreira
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  4. Antônio Fernando Furlan Pinotti
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  5. Francisco Veríssimo Veronese
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  6. Paula Maria Eidt Rovedder
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by FPA and GCB. The first draft of the manuscript was written by FPA and GCB, and all the authors commented on previous versions of the manuscript. All the authors have read and approved the final version.

Corresponding author

Correspondence to Francini Porcher Andrade.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was approved by the Ethics and Research Committee of Hospital de Clínicas de Porto Alegre, under number CAAE 40167014.3.0000.5327.

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Informed consent was obtained from all individual participants included in the study.

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All the authors agreed with the content and gave explicit consent to submit, and obtained consent from the responsible authorities at the organization where the work has been carried out, before the work is submitted.

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Borba, G.C., Andrade, F.P., de Souza Ferreira, T. et al. Estimation of pulmonary artery systolic pressure in hemodialysis patients and its association with cardiorespiratory fitness and pulmonary function. Int Urol Nephrol 55, 961–968 (2023). https://doi.org/10.1007/s11255-022-03381-4

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