Risk Factors For Pulmonary Hypertension In Patients With Peritoneal Dialysis

Objective This retrospective survey was intended to explore the prevalence and analyze potential risk factors of pulmonary hypertension(PH)in patients with peritoneal dialysis(PD.Methods 109 patients with PD over 3 months were included from January 2010 to January 2016 in this study.Pulmonary artery systolic pressure(PASP)were tested by Doppler echocardiography in patients.According to measuring the PASP,the patients were divided into PH group and non pulmonary hypertension(N-PH)group.Their clinical data,laboratory tests and ardiac ultrasound parameters were observed in the two groups.The dialysis-related risk factors in patients with PH were analyzed specifically by Logistic regression.Results In the 109 patients,there were 63 males(57.8%)and 46 females(42.2%)with a mean age of(60.48 ± 14.58)years old.50(45.87%)cases had PH and 59(54.13%)cases had no-pulmonary-hypertension(N-PH).73(67%)cases had glomerulonephritis.22(20%)cases had diabetic nephropathy.9(8%)cases had hypertensive nephropathy.5(5%)cases had other nephropathy(gouty nephropathy,HBV associated nephropathy,obstructive nephropathy,Tumor associated nephropathy).There were no significant differences regarding age,gender,body height,weight,dialysis duration,primary disease,blood urea nitrogen,serum creatinine,calcium,phosphorus,parathyroid hormone,triglyceride,total cholesterol between PH group and N-PH group(all P>0.05).Compared with the patients with N-PH,the patients with PH had lower level of plasma-albumin(ALB),hemoglobin(Hb)and left ventricular ejection fraction(LVEF);and had higher left of atrial diameter(LAD),main pulmonary artery(MPAD),left ventricular end-systolic diameter(LVDs),left ventricular end-diastolic diameter(LVDd),interventricular septal thickness(IVST)and calcium-phosphorus product(all P<0.05).Single factor retrospective analysis showed that decreasing of ALB(OR=0.814,P<0.001),Hb(OR=0.968,P=0.002),LVEF(OR=0.651,P=0.027)and increasing of calcium-phosphorus product(OR=1.523,P=0.035),LAD(OR=1.148,P=0.001),LVDd(OR=1.088,P=0.013),LVDs(OR=1.121,P=0.003)were risk factors for PH in patients with PD.Multivariate retrospective analysis showed that ALB(OR=0.786,P<0.001),LAD(OR=1.117,P=0.018)and calcium-phosphorus product(OR=2.509,P=0.005)were independent risk factors for PH in patients with PD.Conclusions PH is prevalent in PD patients.The decreasing of ALB and increasing of LAD,calcium-phosphorus product may be independent risk factors for PH in patients with PD.