The following is a summary of “Pulmonary hypertension and chronic kidney disease: prevalence, pathophysiology and outcomes,” published in the June 2024 issue of Nephrology by Zeder et al.
Pulmonary hypertension (PH) is a common complication in patients with chronic kidney disease (CKD), affecting a significant proportion and negatively impacting health outcomes.
Researchers conducted a retrospective study exploring the complex relationship between CKD and PH, particularly in understanding its varied pathophysiology and clinical presentation.
They examined existing literature to characterize the diverse manifestations of CKD-related PH. Studies focusing on pulmonary vascular changes, cardiac function, and outcomes in patients with CKD and PH were analyzed.
The results showed that among patients with PH, CKD stages 3 and 4 have a high prevalence, up to 36%; 2 distinct CKD–PH subgroups were identified, 1 characterized by elevated left ventricular filling pressure and volume overload, leading to pulmonary vascular stiffening and post-capillary PH. Meanwhile, increased pulmonary vascular resistance and right ventricular dysfunction without pulmonary venous hypertension may represent a right-sided cardiorenal syndrome defined in principle by hypervolemia, salt avidity, low cardiac output, and normal left ventricular function.
Investigators concluded that more needed to be understood about PH in CKD, which heavily influences decisions about kidney replacement or transplants. It was critical to improve outcomes for high-risk.
Source: nature.com/articles/s41581-024-00857-7
