End Stage Renal Disease-Associated Pulmonary Hypertension

Epidemiology

  • Pulonary hypertension has been reported to occur in ESRD on chronic (long-term) HD

Physiology

  • Potential Mechanisms of Pulmonary Hypertension
    • Hormonal and metabolic derangement associated with ESRD might lead to pulmonary vascular constriction
    • High cardiac output (resulting from the arteriovenous access itself and often concomitant anemia)
    • Fluid overload
    • Diastolic and systolic left heart dysfunction

Clinical Presentation

  • Pulmonary Hypertension (see Pulmonary Hypertension, [[Pulmonary Hypertension]]): present in approximately 40% of ESRD patients on chronic HD (when assessed by Echo)

References

  • Yigla M, Nakhoul F, Sabag A, et al. Pulmonary hypertension in patients with end-stage renal disease. Chest 2003;123:1577–82
  • Nakhoul F, Yigla M, Gilman R, Reisner SA, Abassi Z. The pathogenesis of pulmonary hypertension in haemodialysis patients via arterio-venous access. Nephrol Dial Transplant 2005;20:1686 –92