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Research article
Yannick Mompango Engole
University Hospital of Kinshasa
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8795-5525
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Cardiovascular diseases in particular Pulmonary arterial hypertension (PAH) is associed a high morbi-mortality in chronic hemodialysis, but it’s magnitude remains paradoxically unknown in sub-Saharan Africa. The aim of this study was to evaluate the prevalence of PAH and associated factors in chronic hemodialysis patients.
Patients and method: In a cross-sectional study, patients treated with HD for at least 6 months in 4 hemodialysis centers were examined. PAH was defined as estimated systolic pulmonary arterial pressure (sPAP) ≥ 35 mmHg using transthoracic Doppler echocardiography performed 24 hours after the session.
Results: A total of 85 HD patients were included. Their average age was 54.6 ± 14.3 years. 57 patients (67.1%) were male. Mean duration of HD was 13.3 ± 11 months. With reference to vascular access, 12 (14.1%), 29 (34.1%) and 44 (51.8%) patients had AVF, tunneled cuff and temporary catheter, respectively. The underlying cause of ESRD was diabetes in 30 patients (35.3%). The prevalence of PAH was 29.4%. In multivariate analysis, no secure healthcare funding (adjusted OR 5, 95% CI [1.24-8.27]), hyponatremia (adjusted OR 2, 95% CI [1.61-10.01]), arrhythmia (aOR 3, 95% CI [1.06 -5.85]), vascular access change (aOR 4, 95% CI [1.12-6.23]) and diastolic dysfunction (aOR 5, 95% CI [1.35-9.57] were independently associated with PAH.
Conclusion: One third of hemodialysis patients exhibit PAH, which is associated with diastolic dysfunction and arrhythmia. Therefore, early detection and control of PAH and associated factors may help to tackle PAH associated morbidity and mortality in maintenance hemodialysis patients.
Keywords: Pulmonary hypertension, Hemodialysis, Systolic pulmonary arterial pressure, Cardiovascular disease.
Keywords
Pulmonary hypertension, Hemodialysis, Systolic pulmonary arterial pressure, Cardiovascular disease
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View the published article at BMC Nephrology.
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Editorial decision: Major revision
On 20 May, 2020
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Reviewer #2 agreed
On 08 Apr, 2020
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Received 05 Feb, 2020
Reviewer #1 agreed
On 01 Feb, 2020
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On 23 Jan, 2020
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On 16 Jan, 2020
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On 16 Jan, 2020
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Subject Areas
Urology & Nephrology
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A new preprint design is coming!
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See the published version of this preprint at BMC Nephrology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yannick Mompango Engole
University Hospital of Kinshasa
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8795-5525
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Nephrology.
Version 1
Posted 20 Jan, 2020
No community comments so far
Editorial decision: Major revision
On 20 May, 2020
Review #2 received
Received 12 May, 2020
Reviewer #2 agreed
On 08 Apr, 2020
Review #1 received
Received 05 Feb, 2020
Reviewer #1 agreed
On 01 Feb, 2020
Editor assigned
On 23 Jan, 2020
Reviewers invited
Invitations sent on 23 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor invited
On 16 Jan, 2020
First submitted
On 07 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Nephrology.
Background: Cardiovascular diseases in particular Pulmonary arterial hypertension (PAH) is associed a high morbi-mortality in chronic hemodialysis, but it’s magnitude remains paradoxically unknown in sub-Saharan Africa. The aim of this study was to evaluate the prevalence of PAH and associated factors in chronic hemodialysis patients.
Patients and method: In a cross-sectional study, patients treated with HD for at least 6 months in 4 hemodialysis centers were examined. PAH was defined as estimated systolic pulmonary arterial pressure (sPAP) ≥ 35 mmHg using transthoracic Doppler echocardiography performed 24 hours after the session.
Results: A total of 85 HD patients were included. Their average age was 54.6 ± 14.3 years. 57 patients (67.1%) were male. Mean duration of HD was 13.3 ± 11 months. With reference to vascular access, 12 (14.1%), 29 (34.1%) and 44 (51.8%) patients had AVF, tunneled cuff and temporary catheter, respectively. The underlying cause of ESRD was diabetes in 30 patients (35.3%). The prevalence of PAH was 29.4%. In multivariate analysis, no secure healthcare funding (adjusted OR 5, 95% CI [1.24-8.27]), hyponatremia (adjusted OR 2, 95% CI [1.61-10.01]), arrhythmia (aOR 3, 95% CI [1.06 -5.85]), vascular access change (aOR 4, 95% CI [1.12-6.23]) and diastolic dysfunction (aOR 5, 95% CI [1.35-9.57] were independently associated with PAH.
Conclusion: One third of hemodialysis patients exhibit PAH, which is associated with diastolic dysfunction and arrhythmia. Therefore, early detection and control of PAH and associated factors may help to tackle PAH associated morbidity and mortality in maintenance hemodialysis patients.
Keywords: Pulmonary hypertension, Hemodialysis, Systolic pulmonary arterial pressure, Cardiovascular disease.
Figure 1
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