Pulmonary hypertension in CKD

Davide Bolignano, Stefania Rastelli, Rajiv Agarwal, Danilo Fliser, Ziad Massy, Alberto Ortiz, Andrzej Wiecek, Alberto Martinez-Castelao, Adrian Covic, David Goldsmith, Gultekin Suleymanlar, Bengt Lindholm, Gianfranco Parati, Rosa Sicari, Luna Gargani, Francesca Mallamaci, Gerard London, Carmine Zoccali

Research output: Contribution to journalArticle

Abstract

Pulmonary arterial hypertension is a rare disease often associated with positive antinuclear antibody and high mortality. Pulmonary hypertension, which rarely is severe, occurs frequently in patients with chronic kidney disease (CKD). The prevalence of pulmonary hypertension ranges from 9%-39% in individuals with stage 5 CKD, 18.8%-68.8% in hemodialysis patients, and 0%-42% in patients on peritoneal dialysis therapy. No epidemiologic data are available yet for earlier stages of CKD. Pulmonary hypertension in patients with CKD may be induced and/or aggravated by left ventricular disorders and risk factors typical of CKD, including volume overload, an arteriovenous fistula, sleep-disordered breathing, exposure to dialysis membranes, endothelial dysfunction, vascular calcification and stiffening, and severe anemia. No specific intervention trial aimed at reducing pulmonary hypertension in patients with CKD has been performed to date. Correcting volume overload and treating left ventricular disorders are factors of paramount importance for relieving pulmonary hypertension in patients with CKD. Preventing pulmonary hypertension in this population is crucial because even kidney transplantation may not reverse the high mortality associated with established pulmonary hypertension.

Original languageEnglish
Pages (from-to)612-622
Number of pages11
JournalAmerican Journal of Kidney Diseases
Volume61
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • chronic kidney disease
  • hemodialysis
  • peritoneal dialysis
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Bolignano, D., Rastelli, S., Agarwal, R., Fliser, D., Massy, Z., Ortiz, A., Wiecek, A., Martinez-Castelao, A., Covic, A., Goldsmith, D., Suleymanlar, G., Lindholm, B., Parati, G., Sicari, R., Gargani, L., Mallamaci, F., London, G., & Zoccali, C. (2013). Pulmonary hypertension in CKD. American Journal of Kidney Diseases, 61(4), 612-622. https://doi.org/10.1053/j.ajkd.2012.07.029