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Risk Factors for Pulmonary Hypertension in Patients Undergoing Peritoneal Dialysis
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A5715 - Risk Factors for Pulmonary Hypertension in Patients Undergoing Peritoneal Dialysis
Author Block: V. Jayaschandran1, M. Kwon2, H. Iftikhar3, A. Michel4, B. D. Dalal5; 1Internal Medicine, Oakland University William Beaumont, Royal Oak, MI, United States, 2Pulmonary and Critical Care Medicine, Jacksonville, FL, United States, 3Internal Medicine, Beaumont Health, Royal Oak, MI, United States, 4Internal Medicine, Oakland University William Beaumont, Royal oak, MI, United States, 5Oakland University William Beaumont, Royal Oak, MI, United States.
Rationale: Pulmonary hypertension is extremely prevalent in End Stage Renal Disease (ESRD) patients on peritoneal dialysis (PD). We conducted a retrospective study to identify risk factors for development of pulmonary hypertension in this population.
Methods: Retrospective chart review identified patients on PD managed at our institution who had undergone at least one echocardiogram over an 8-year period between 2009 and 2017. Pulmonary hypertension was defined by Right Ventricular Systolic Pressure (RVSP) > 35 mm Hg. Demographic variables, biochemical data (documented around the time when echocardiogram was performed) as well as echocardiographic variables were collected and their association with pulmonary hypertension in this population was assessed by regression analysis.
Results: 77 patients met the entry criteria for analysis. Mean duration between initiation of PD and echocardiogram was 1.6 years. Sample comprised 42 males, 35 females, with mean age of 67.8 years. 15 patients had a history of undergoing hemodialysis in the past. Mean RVSP for the sample was 38.6 mm Hg with 42 patients (54.5%) having RVSP more than 35 mm Hg. Univariate regression analysis identified LVIDs (left ventricular internal diameter end systole), e/a ratio, mitral valve deceleration time, left atrial diameter and creatinine level to have statistically significant association with RVSP. On performing multivariate analysis, e/a ratio, mitral valve deceleration time and left atrial diameter retained the strong association and are major risk factors for higher RVSP value.
Conclusion: Our study demonstrates the various risk factors that have strong association with development of pulmonary hypertension in PD patients. Further studies are required to test the findings in a larger population
Author Block: V. Jayaschandran1, M. Kwon2, H. Iftikhar3, A. Michel4, B. D. Dalal5; 1Internal Medicine, Oakland University William Beaumont, Royal Oak, MI, United States, 2Pulmonary and Critical Care Medicine, Jacksonville, FL, United States, 3Internal Medicine, Beaumont Health, Royal Oak, MI, United States, 4Internal Medicine, Oakland University William Beaumont, Royal oak, MI, United States, 5Oakland University William Beaumont, Royal Oak, MI, United States.
Rationale: Pulmonary hypertension is extremely prevalent in End Stage Renal Disease (ESRD) patients on peritoneal dialysis (PD). We conducted a retrospective study to identify risk factors for development of pulmonary hypertension in this population.
Methods: Retrospective chart review identified patients on PD managed at our institution who had undergone at least one echocardiogram over an 8-year period between 2009 and 2017. Pulmonary hypertension was defined by Right Ventricular Systolic Pressure (RVSP) > 35 mm Hg. Demographic variables, biochemical data (documented around the time when echocardiogram was performed) as well as echocardiographic variables were collected and their association with pulmonary hypertension in this population was assessed by regression analysis.
Results: 77 patients met the entry criteria for analysis. Mean duration between initiation of PD and echocardiogram was 1.6 years. Sample comprised 42 males, 35 females, with mean age of 67.8 years. 15 patients had a history of undergoing hemodialysis in the past. Mean RVSP for the sample was 38.6 mm Hg with 42 patients (54.5%) having RVSP more than 35 mm Hg. Univariate regression analysis identified LVIDs (left ventricular internal diameter end systole), e/a ratio, mitral valve deceleration time, left atrial diameter and creatinine level to have statistically significant association with RVSP. On performing multivariate analysis, e/a ratio, mitral valve deceleration time and left atrial diameter retained the strong association and are major risk factors for higher RVSP value.
Conclusion: Our study demonstrates the various risk factors that have strong association with development of pulmonary hypertension in PD patients. Further studies are required to test the findings in a larger population
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