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