Risk Factors Analysis For Pulmonary Artery Hypertension In Patients With Peritoneal Dialysis

Objective:This study investigated the risk factors associated with pulmonary artery hypertension(PAH)in patients with peritoneal dialysis(PD)by evaluation of general status for patients with peritoneal dialysis.Method:The 120 patients with end-stage renal disease(ESRD)undergoing peritoneal dialysis in our hospital during the period from Jan 2010 to June 2015 were divided into the PAH group(30 cases)and the non-PAH group(90 cases)according to whether combination with pulmonary artery hypertension.There were no statistical difference between two groups in gender,age,dialysis age,systolic blood pressure,diastolic blood pressure,primary disease,BMI,and so on.The index such as hemoglobin(Hb),creatinine,urea nitrogen,albumin(Alb),blood calcium,blood phosphorus,parathyroid hormone(iPTH),left atrial diameter(LAD),left ventricular systolic diameter(LVDs),left ventricular end diastolic diameter(LVDd),left ventricular ejection fraction(LVEF),early peak flow velocity(E),atrium peak flow velocity(A),E/A,interventricular septum thickness,left ventricular posterior wall thickness pericardial effusion,mitral valve calcification,left ventricular mass index(LVMI)were detected,compared in two groups and found whether there was statistical significance.The single factor analysis statistical method were applied to analyze the related factors in peritoneal dialysis patients combined with pulmonary artery hypertension;the COX analysis were applied in aboved factors to investigate the related risk factors in peritoneal dialysis patients combined with pulmonary artery hypertension.Results:Compared with the non-PAH group,the levels of Hb(88.7±12.3 vs 99.6±16.7 g/L,t=4.02,P<0.05),serum iron(7.1 ±0.5 vs 8.9±0.6mmol/L,t=3.49,P<0.05),and albumin(27.5±5.7 vs 33.4±5.2 g/L,t=4.07,P<0.05)were significantly decreased and the levels of the calcium phosphorus prodct(4.0± 1.7 vs 1.9± 1.2,t=3.73,P<0.05),serum parathyroid hormone(398±34 vs 217±31ng/mL,t=3.59,P<0.05)were obviously increased with statistical difference in PAH group;compared with the non-PAH group,the index such as left ventricular diastolic diameter(5.7±0.4 vs 5.0±0.3 cm,t=4.19,P<0.05),lfet ventricular systolic diameter(4.0±0.3 vs 3.5±0.4 cm,t=3.47,P<0.05),left atrial diameter(4.3±0.4 vs 3.8±0.3 cm,t=3.68,P<0.05),left ventricular mass index(171.5±45.3 vs 134.7±33.4 g/m2,t=4.69,P<0.05),pericardial effusion(26.7%vs 10.0%,?2=4.02,P<0.05)and mitral valve calcification(26.7%vs 10.0%??2=4.02,P<0.05)were obviously increased with statistical difference in PAH group;there were no satistical difference between two groups for the levels of 24h urine volume,24h ultrafiltration volume and peritoneal equilibrium test(PET);the COX analysis were applied in aboved related factors with statistical difference(hemoglobin,serum iron,albumin,calcium phosphorus prodct,serum parathyroid hormone,left ventricular diastolic diameter,lfet ventricular systolic diameter,left atrial diameter,left ventricular mass index,pericardial effusion,mitral valve calcification),the results showed that hemoglobin,albumin,left ventricular diastolic diameter and mitral valve calcification were the independent risk factors for peritoneal dialysis combination with pulmonary artery hypertension.Conclusion:When anemia or left ventricular systolic dysfunction for patients with peritoneal dialysis,the incidence of pulmonary artery hypertension is increasing.Hemoglobin,albumin,left ventricular diastolic diameter and mitral valve calcification are the independent risk factors for peritoneal dialysis patients with pulmonary artery hypertension.