Outcome of pulmonary hypertension in patient on dialysis following kidney transplantation: an observational study

Authors

  • Vasanth G. Department of Nephrology, PSGIMS&R, Coimbatore, Tamilnadu, India
  • Siva N. Department of Nephrology, PSGIMS&R, Coimbatore, Tamilnadu, India
  • Rajendran G. Department of Cardiology, PSGIMS&R, Coimbatore, Tamilnadu, India
  • Venu G. Department of Nephrology, PSGIMS&R, Coimbatore, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20183388

Keywords:

Dialysis, Pulmonary hypertension, Transplant

Abstract

Background: Pulmonary hypertension (PH) is common among patients with end stage renal disease (ESRD) who are on dialysis and PH is associated with higher mortality rates among these patients. The impact of kidney transplantation on pulmonary hypertension is unknown. The purpose of this study is to evaluate the impact of successful kidney transplantation on pulmonary arterial hypertension in these patients on dialysis.

Methods: The study was conducted on patients who underwent kidney transplantation in Department of Nephrology PSGIMSR. Patients with pulmonary hypertension pre transplant were taken up for the study after the application of inclusion and exclusion criteria and after obtaining consent. Demographic, clinical information and laboratory results were collected. The assessment of PH was done by Doppler echocardiography pre transplant and   3 and 6 months after transplant during follow up.

Results: The prevalence of PH was 40%. The mean age of study population was 42 ± 8.7 years. The mean dialysis duration of study population was 32±8 months. 54.5% were male. 45.5% were female. Out of the 55 transplant recipients, 22 patients had elevated PASP on preoperative echocardiography examination.  Compared to pre-transplant values, a significant decrease was observed in mean SPAP values and the severity of pulmonary hypertension 3 and6 months postoperative follow up (p<0.003).

Conclusions: The prevalence of pre-operative PH among dialysis patient was high. Kidney transplantation leads to considerable improvement in pulmonary arterial hypertension in patients on dialysis.

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References

Yigla M, Nakhoul F, Sabag A, Tov N, Gorevich B, Abassi Z, Reisner SA. Pulmonary hypertension in patients with end stage renal disease. Chest. 2003;123:1577-82.

Havlucu Y, Kursat S, Ekmekci C, Celik P, Serter S, Bayturan O, et al. Pulmonary hypertension in patients with chronic renal failure. Respiration. 2007;74:503-10.

Tarrass F, Benjelloun M, Medkouri G, Hachim K, Benghanem MG, Ramdani B. Doppler echocardiograph evaluation of pulmonary hypertension in patients undergoing hemodialysis. Hemodial Int. 2006;10:356-9.

Bozbas SS, Akcay S, Altin C, Bozbas H, Karacaglar E, Kanyilmaz S, Sayin B, Muderrisoglu H, Haberal M. Pulmonary hypertension in patients with end-stage renal disease undergoing renal transplantation. Transplant Pro. 2009;41:2753-6.

Abassi Z, Nakhoul F, Khankin E, Reisner SA, Yigla M. Pulmonary hypertension in chronic dialysis patients with arteriovenous fistula: pathogenesis and therapeutic prospective. Curr Opin Nephrol Hyper. 2006;15:353360.

Jeffery TK, Morelli NW: Molecular and cellular basis of pulmonary vascular remodeling in pulmonary hypertension. Prog Cardiovasc Dis. 2002;45:173-202.

Vaziri ND: Effect of chronic renal failure on nitric oxide metabolism. Am J Kidney Dis. 2001;38:S74-S79.

Yigla M, Fruchter O, Aharonson D, Yanay N, Reisner SA, Lewin M, Nakhoul F. Pulmonary hypertension is an independent predictor of mortality in hemodialysis patients. Kidney Int. 2009;75:969-75.

Kosmadakis G, Aguilera D, Carceles O, Da Costa Correia E, Boletis I. Pulmonary hypertension in dialysis patients. Renal failure. 2013 May 1;35(4):514-20.

Merlos P, Núñez J, Sanchis J, Miñana G, Palau P, Bodí V, et al. Echocardiographic estimation of pulmonary arterial systolic pressure in acute heart failure. Prognostic implications. Euro J Inter Med. 2013 Sep 1;24(6):562-7.

David M. Zlotnick, David A. Axelrod, Michael C. Chobanian, Scott Friedman, Jeremiah Brown, Edward Catherwood, Salvatore P. Costa; Non-invasive detection of pulmonary hypertension prior to renal transplantation is a predictor of increased risk for early graft dysfunction, Nephrology Dialysis Transplantation. 2010;25(9):3090-6

Casas-Aparicio G, Castillo-Martinez L, Orea-Tejeda A, Abasta-Jiménez M, Keirns-Davies C, et al. The effect of successful kidney transplantation on ventricular dysfunction and pulmonary hypertension. InTransplantation proceedings 2010 Nov 1 (Vol. 42, No. 9, pp. 3524-3528). Elsevier.

Simmons EM, Langone A, Sezer MT, Vella JP, Recupero P, Morrow JD, et al. Effect of renal transplantation on biomarkers of inflammation and oxidative stress in end-stage renal disease patients. Transplantation. 2005 Apr 27;79(8):914-9.

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Published

2018-08-25

How to Cite

G., V., N., S., G., R., & G., V. (2018). Outcome of pulmonary hypertension in patient on dialysis following kidney transplantation: an observational study. International Journal of Research in Medical Sciences, 6(9), 2948–2951. https://doi.org/10.18203/2320-6012.ijrms20183388

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Original Research Articles