Background: Pulmonary hypertension (PH) has been recognized frequently in patients with chronic renal failure undergoing hemodialysis. Some studies have suggested that PH may be associated with a worse prognosis of renal transplant candidates.
Objective: To determine the prevalence of findings suggestive of PH in patients eligible for kidney transplantation and its effect on patient survival
Methods: This is a retrospective study of patients evaluated for renal transplant in the Department of Nephrology, Hospital de Clinicas de Porto Alegre (HCPA) from January to December 2010. For study proposal, follow up finished in October 2012. The color Doppler echocardiography is a routine examination in the cardiorespiratory evaluation. Echocardiographic findings suggestive of PH were tricuspid regurgitant velocity (TRV) of greater than 2.8 m/s, pulmonary artery acceleration time less than 120 ms or right ventricular dilatation (diameter greater than 2.6 cm). Data were extracted from electronic medical records of HCPA
Results: During the study period were included 81 patients with a mean age of 49.4 years (SD ±11.7, between 22 and 72 years), mostly male (n = 46, 56.8%) and caucasians (n = 57, 72.2%). The main causes of chronic renal failure were hypertension (n = 32, 39.5%), diabetes mellitus (n = 19, 23.4%) and polycystic kidney disease (n = 9, 11.1%). Echocardiographic TRV were 2.61 m/s (SD ± 1.32 m/s), allowed to estimate systolic pulmonary artery of 33.8 mm Hg (SD ± 9.2 mmHg). The diameter of the right ventricle was 2.1 cm (SD ± 0.38 cm). Overall, findings suggestive of pulmonary hypertension were found in 10 patients (12.3%). The only factor associated with the presence of PH was the duration of hemodialysis (p = 0.02). The mean follow-up was 23.3 months (SD ± 7.7 months). The total mortality rate was 8.6% (n = 7), and 3 deaths were in patients with PH (mortality rate of 30%). The presence of pulmonary hypertension identified at echocardiography was associated with higher mortality (p = 0.01), as well as duration of hemodialysis (p <0.01), blood transfusions (p = 0.03) and male gender (p = 0.01)
Conclusions: Echocardiographic findings suggestive of pulmonary hypertension are prevalent in renal transplant candidates and their presence is associated with higher mortality.
To cite this abstract in AMA style:Ribeiro A, Gazzana M, Vicari A, Knorst M, Manfro R. Pulmonary Hypertension Identified by Color Doppler Echocardiography in Renal Transplant Candidates: Prevalence and Effect on Survival [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/pulmonary-hypertension-identified-by-color-doppler-echocardiography-in-renal-transplant-candidates-prevalence-and-effect-on-survival/. Accessed October 27, 2020.
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