Analysis of Clinically Relevant Factors for Pulmonary Hypertension in Maintenance Hemodialysis Patients
Shen Shen, Qianmei Sun
Department of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
Med Sci Monit 2015; 21:4050-4056
Pulmonary hypertension (PH) is common in patients with maintenance hemodialysis (MHD) and is associated with high mortality. This study analyzed clinically relevant factors for pulmonary hypertension in MHD patients and the effect of serum pentraxin3 (PTX3) in the pathogenesis of PH to provide the basis for early diagnosis and treatment of MHD patients with PH.
MATERIAL AND METHODS: This study included 60 MHD patients (group A) and 30 healthy controls (group B). Group A was further divided into PH and non-PH groups. Clinical characteristics, auxiliary examination results and serum PTX3 level of the PH and non-PH groups were compared. Binary logistic regression was used to assess the risk factors for PH in MHD patients. ROC curve was applied to evaluate the diagnostic value of PTX3 in PH.
RESULTS: The incidence rate of PH in MHD patients was 50%, and most presented as mild to moderate. Compared with the non-PH group, patients in PH group presented significantly longer atrial diameter, right ventricular diameter and main pulmonary artery diameter (P<0.05), as well as higher PTX3 and NT-proBNP level. Atrial diameter and PTX3 level were the risk factors for PH in MHD patients. AUC of PTX3 was 0.721 (95%CI: 0.590–0.851, P=0.003).
CONCLUSIONS: The prevalence of PH was higher in MHD patients and mostly presented as mild to moderate. Such patients often developed heart structural changes and cardiac ultrasound was highly recommended. Serum PTX3 level was significantly elevated and could be used as a marker of PH in MHD patients.
Keywords: Aged, Adult, C-Reactive Protein - metabolism, Case-Control Studies, Female, Humans, Hypertension, Pulmonary - etiology, Male, Middle Aged, Prevalence, Renal Dialysis - methods, Risk Factors, Serum Amyloid P-Component - metabolism