PAH Incidence And Correlation Analysis Of Patients With Chronic Kidney Disease

[Objective]To explore the occurrence of pulmonary hypertension in patients with chronic kidney disease, analysis risk factors of possible.[Materials and Methods]365Patients with CKD were collected in our data., without other factors that may cause pulmonary arterial hypertension (PAH), The incidence of PAH were compared using χ2test, Comparisons of clinical data among different CKD stage, follow-up in dialysis patients with and without pulmonary artery pressure in dialysis patients were tested by One-Way ANOVA analysis. Paired t test was used for before and after treatment. Comparison of PAH and non PAH patients clinical data, was used to compare the value of Mann-Whitney U test.[Results]The365patients, including207cases of male, female158cases, average age was (54.5±16.7) years (18y～86y), the average duration of (46.9±62.6) months. A total of50cases of PAH patients, the morbidity rate was13.7%, the incidence rate of PAH with the development of CKD was increased (by CKD1-3were5.4%,7.4%,12%, CKD4 18.6%, and CKD524%, P<0.01).315patients in group PAH with higher serum uric acid than that in normal PAP, parathyroid hormone, renin activity (P<0.05), while in the hemoglobin, hematocrit, creatinine, blood urea nitrogen, calcium, phosphorus, calcium phosphorus product, and angiotensin I, angiotensin II has very significant difference (P<0.01). The CKD was significantly related with PAP(r=0.532, P<0.01).The analyses of the related factors with PAP, was positively correlated with Scr、Bun、UA、P3-、 renin、angiotensin,but negatively correlated with Hb、Hct、Ca2+(P<0.01). Ang Ⅱ、Hb、 P3-、PTH were the independent factors for PAP. A series of measures were given to correct anemiad.Calcium and phosphorus metabolism,and RAS inhibitors were used. During follow-up there was non-increased in PAP for patients with tages1-3CKD at6months (p>0.05), PAP for patients with tages4-5CKD was still increased(P<0.01).The patients with high pulmonary artery pressure and young patients are more likely to accept renal replacement therapy. After improved the anemia, PAP decreased. But PAP increased in patients with anemia accelerated (P<0.01). Inhibition of RAS activity, pulmonary artery pressure declined slightly,unlike non users (P<0.01).[Conclusion]Patients with chronic kidney disease easily complicated with pulmonary hypertension, the incidence and severity correlated with the stage of CKD. Toxin accumulation, level of anemia, blood calcium and phosphorus metabolism, parathyroid hormone PAH levels and renin-angiotensin-aldosterone system activation closely correlated with pulmonary hypertension. To correct anemia, calcium and phosphorus metabolism disorder and hyperactive in RAS system, PAP of some patients can reduce.and maybe the onset of PAH will be delayed. Dialysis can be used for the PAH patients who have been accepted conservative treatment,which can further alleviate PAH.