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Yuan S, Li S, Ruan J, Liu H, Jiang T, Dai H. Chronic kidney disease and pulmonary hypertension: Progress in diagnosis and treatment. Transl Res 2024; 273:16-22. [PMID: 38960282 DOI: 10.1016/j.trsl.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024]
Abstract
Pulmonary hypertension (PH) is a medical condition characterized by elevated pulmonary vascular resistance and pressure, resulting from different diseases. Due to their high occurrence of PH, intricate hemodynamic classification, and frequently multifactorial cause and mechanism, individuals suffering from chronic kidney disease (CKD) are categorized as the fifth primary group of PH. Based on both domestic and international research, this article provides information on the epidemiology, risk factors, pathogenesis, and targeted drug treatment of PH associated with CKD.
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Affiliation(s)
- Shanshan Yuan
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao 266011, PR China
| | - Shicheng Li
- Department of Cardiology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, PR China
| | - Jiangwen Ruan
- Department of Cardiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Institute of Cardiovascular Sciences, Guangxi Academy of Medical Sciences, Nanning 530021, PR China
| | - Hui Liu
- Division of Biology and Chemistry, Paul Scherrer Institut, 5232, Villigen, Switzerland; Department of Health Sciences and Technology, ETH Zurich, 8092, Zurich, Switzerland
| | - Tongmeng Jiang
- Key Laboratory of Emergency and Trauma of Ministry of Education, Key Laboratory of Haikou Trauma, Key Laboratory of Hainan Trauma and Disaster Rescue, The First Affiliated Hospital, Hainan Medical University, Haikou 571199, PR China; Engineering Research Center for Hainan Bio-Smart Materials and Bio-Medical Devices, Key Laboratory of Hainan Functional Materials and Molecular Imaging, College of Emergency and Trauma, Hainan Academy of Medical Sciences, Hainan Medical University, Haikou 571199, PR China.
| | - Hongyan Dai
- Department of Cardiology, Qingdao Municipal Hospital, Qingdao 266011, PR China.
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Frost AE, Moore LW, Valdivia e Alvarado M, Obi C, Graviss EA, Nguyen DT, Gaber AO, Suki WN. The echocardiographic course of pretransplant pulmonary hypertension following kidney transplantation and associated outcomes. Pulm Circ 2021; 12:e12030. [PMID: 35506107 PMCID: PMC9052995 DOI: 10.1002/pul2.12030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/17/2021] [Accepted: 12/17/2021] [Indexed: 11/14/2022] Open
Abstract
The post 3 kidney transplant course of pretransplant echocardiographically‐defined pulmonary hypertension (PH) was reviewed in 115 patients. Of these 61 patients (the largest cohort reported to date), underwent 160 “for indication” echocardiograms posttransplant (mean echocardiograms per patient: 2.6 ± 2.3). Patients undergoing posttransplant echocardiograms demonstrated greater risks for worse outcomes than those without posttransplant echocardiograms; however, there was no difference in mortality, death‐censored graft failure or the composite of death or graft failure between these two groups. Of patients tested, 36 (59%) showed resolution of PH at a median of 37.5 months. Six patients (16.7%) in whom PH resolved (at a median of 29 months), experienced recurrence of PH after an interval of 48 months. No pretransplant demographic or echocardiographic characteristics distinguished those in whom PH persisted versus resolved. Though there was no difference in the risk for mortality or death‐censored graft loss between the two groups at 3 and 5 years, there was a higher risk for the composite of mortality or graft loss at three but not at five years in the group with persistent PH. In conclusion, echocardiographically defined PH resolved in 59% of patients following kidney transplantation; but irrespective of resolution there was no clear association with worse outcome.
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Affiliation(s)
- Adaani E Frost
- Houston Methodist Academic Institute Houston Texas
- Houston Methodist Research Institute Houston Texas
| | - Linda W Moore
- Houston Methodist Research Institute Houston Texas
- Dept of Surgery Houston Methodist Hospital Houston Texas
| | | | - Chizoba Obi
- Dept. of Medicine Houston Methodist Hospital Houston Texas
| | - Edward A Graviss
- Houston Methodist Research Institute Houston Texas
- Dept of Surgery Houston Methodist Hospital Houston Texas
| | - Duc T Nguyen
- Houston Methodist Research Institute Houston Texas
| | - A Osama Gaber
- Houston Methodist Research Institute Houston Texas
- Dept of Surgery Houston Methodist Hospital Houston Texas
| | - Wadi N Suki
- Houston Methodist Academic Institute Houston Texas
- Dept. of Medicine Houston Methodist Hospital Houston Texas
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