Association of Pulmonary Hypertension With Inflammation and Fluid Overload in Hemodialysis Patients

Authors

  • Hugo Hyung Bok Yoo Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Roberto Dos Reis Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Wagner Moneda Telini Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Lidiane Rodrigues Telini Division of Nephrology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • João Carlos Hueb Division of Cardiology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Silmeia Garcia Zanati Bazan Division of Cardiology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Pasqual Barretti Division of Nephrology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Luis Cuadrado Martin Division of Nephrology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author
  • Thais Thomaz Queluz Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil Author

Abstract

Introduction. Pulmonary hypertension (PH) has been reported in hemodialysis patients, but data regarding its pathogenesis are scarce. This study aimed to evaluate the role of fluid overload in PH and its interrelationships with the usual biomarkers of micro-inflammatory state in hemodialysis patients.

Materials and Methods. In is a cross-sectional and prospective study, 119 consecutive hemodialysis patients at a Brazilian referral university hospital were evaluated between March 2007 and February 2013. Based on the presence of echocardiographic parameters of PH, patients were allocated to two groups of the PH group and the non-PH group. Clinical parameters, site and type of vascular access, bio-impedance, and laboratory findings were compared between the two groups and a logistic regression model was elaborated.

Results. Pulmonary hypertension was found in 23 (19.0%) of 119 patients. The groups significantly differed in extracellular water, ventricular thickness, left atrium diameter, and ventricular filling. Additionally, laboratory data associated with PH were alpha-1-acid glycoprotein (140.0 ± 32.9 versus 116.0 ± 35.5; P < .001); C-reactive protein (median, 1.1 versus 1.6; P = .01) and B-type natriuretic peptide (median, 328 versus 77; P = .03). The adjusted logistic regression model, including alpha-1-acid glycoprotein and B-type natriuretic peptide, showed significant associations for both (odds ratio, 1.023; 95% confidence interval, 1.008 to 1.043;  P = .004 and odds ratio, 3.074; 95% confidence interval, 1.49-6.35; P = .002, respectively).

Conclusions. Pulmonary hypertension, cardiac hypertrophy, fluid overload, and inflammation were associated to each other in hemodialysis patients, providing insight into its pathogenesis. Longitudinal studies are warranted.

Downloads

Download data is not yet available.

Author Biographies

  • Hugo Hyung Bok Yoo, Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Pulmonary Division- Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Roberto Dos Reis, Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Pulmonary Division- Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Wagner Moneda Telini, Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Pulmonary Division- Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Lidiane Rodrigues Telini, Division of Nephrology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • João Carlos Hueb, Division of Cardiology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Cardiology Division-Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Silmeia Garcia Zanati Bazan, Division of Cardiology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Cardiology Division-Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Pasqual Barretti, Division of Nephrology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Nephrology Division-Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Luis Cuadrado Martin, Division of Nephrology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Nephrology Division-Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

  • Thais Thomaz Queluz, Division of Pulmonology, Botucatu School of Medicine, Sao Paulo State University, Botucatu, Brazil

    Pulmonary Division-Department of Internal Medicine

    Botucatu Medical School - São State University-UNESP

Downloads

Published

2017-06-02

Issue

Section

ORIGINAL | Dialysis

How to Cite

Association of Pulmonary Hypertension With Inflammation and Fluid Overload in Hemodialysis Patients. (2017). Iranian Journal of Kidney Diseases, 11(4), 303-308. https://ijkd.org/index.php/ijkd/article/view/3009