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Relationship between pulmonary hypertension, peripheral vascular calcification, and major cardiovascular events in dialysis patients

Authors
Kim S.C.Chang H.J.Kim M.-G.Jo S.-K.Cho W.-Y.Kim H.-K.
Issue Date
1-Mar-2015
Publisher
Elsevier
Keywords
Cardiovascular disease; Dialysis; Pulmonary hypertension
Citation
Kidney Research and Clinical Practice, v.34, no.1, pp 28 - 34
Pages
7
Indexed
SCOPUS
KCI
Journal Title
Kidney Research and Clinical Practice
Volume
34
Number
1
Start Page
28
End Page
34
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/8474
DOI
10.1016/j.krcp.2015.01.003
ISSN
2211-9132
2211-9140
Abstract
Background Pulmonary hypertension (PHT) is a recently recognized complication of chronic kidney disease. In this study, we investigated the association between PHT, peripheral vascular calcifications (VCs), and major cardiovascular events. Methods In this retrospective study, we included 172 end-stage renal disease (ESRD) patients undergoing dialysis [hemodialysis (HD)=84, peritoneal dialysis=88]. PHT was defined as an estimated pulmonary artery systolic pressure>37 mmHg using echocardiography. The Simple Vascular Calcification Score (SVCS) was measured using plain radiographic films of the hands and pelvis. Results The prevalence of PHT was significantly higher in HD patients (51.2% vs. 22.7%). Dialysis patients with PHT had a significantly higher prevalence of severe VCs (SVCS≥ 3). In multivariate analysis, the presence of severe VCs [odds ratio (OR), 2.68], mitral valve disease (OR, 7.79), HD (OR, 3.35), and larger left atrial diameter (OR, 11.39) were independent risk factors for PHT. In addition to the presence of anemia, severe VCs, or older age, the presence of PHT was an independent predictor of major cardiovascular events in ESRD patients. Conclusion The prevalence of PHT was higher in HD patients and was associated with higher rates of major cardiovascular events. Severe VCs are thought to be an independent risk factor for predicting PHT in ESRD patients. Therefore, in dialysis patients with PHT, careful attention should be paid to the presence of VCs and the occurrence of major cardiovascular events. © 2015. The Korean Society of Nephrology. Published by Elsevier. All rights reserved.
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Anam Hospital (Department of Nephrology and Hypertension, Anam Hospital)
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