Study of pulmonary hypertension in chronic kidney disease and correlation of pulmonary hypertension with staging of chronic kidney diseases in tertiary care center in central India

Abstract

Background: Pulmonary hypertension (PH) has been recently reported to be a common comorbidity in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The present study was conducted to analyze the prevalence of PH in patients with CKD, its severity in different stages of CKD, and risk factors for it. Method: A total171 patients of age
>18 years, diagnosed with CKD were included in the study and were classified in various stages of CKD (1-5) according to eGFR. eGFR was calculated by the MDRD formula (KDIGO2010).Result: Among total CKD patients, 53.22% were in stage V, 26.9% in stage IV and
19.88% in Stage III. Low hemoglobin, high phosphorus, high Ca-po4 product, and high serum
creatinine were significantly associated with higher stages of CKD, (P<0.05).Prevalence of PH
in CKD patients was 39.18%. Among these 59 had mild PH, 8 had moderate PH.Maximum
patients with PH were having etiology of combined diabetes mellitus with hypertension,
(P<0.05). Patients of CKD having duration of >5 years, patients on hemodialysis and patients
with AV fistula had a greater number of PH with significant p value, (P<0.05). The relation of
PH according to stage of CKD showed that Stage V had greater PH compared to Stage III,
(P<0.05).Patients with Stage V had more patients with moderate PH compared to patients with
Stage III, (P<0.05)Conclusion: PH is more prevalent in patients with CKD. The severity of PH
directly correlates with Stages of CKD i.e., an increase in severity of PAH occurs with
deterioration of renal function in CKD cases.