Hipertensão pulmonar em pacientes com doença renal crônica terminal internados em um hospital de referência em nefrologia do estado do Pará, Brasil

Abstract

OBJECTIVES: To verify the existence of pulmonary arterial hypertension (PAH) among patients with chronic kidney disease (CKD) undergoing hemodialysis, and to identify their clinical profiles. MATERIALS AND METHODS: A retrospective study was carried out by analyzing the medical records of patients admitted to a referral hospital in nephrology in Pará State, Brazil, from January to December 2014. Variables as age, gender, comorbidities, reason for hospitalization, type of vascular access were obtained by a questionnaire and analyzed. In addition, transthoracic Doppler echocardiography information, such as pulmonary artery systolic pressure (PASP), with values ≥ 35 mmHg suggesting PAH, was considered. RESULTS: From the total of 101 patients investigated, 21.8% presented signs suggestive of PAH, and 63.6% of those were male with mean age of 60.36 ± 12.35 years. Mean PASP was 51.13 ± 11.40 mmHg and the majority of hospitalizations were due to uremia (45.5%) and acute coronary syndrome (13.6%). Among the main comorbidities identified, systemic arterial hypertension (95.5%) and diabetes mellitus (50.0%) stand out. Most of patients used the Shilley vascular access for hemodialysis (95.5%), and the most reported outcome was death (36.4%). CONCLUSION: Screening for PAH by echocardiography may be useful for cardiopulmonary evaluation among uremic patients, and prospective studies are needed to clarify the relationship between PAH and hemodialysis therapy in patients with CKD.