Comparison of Pulmonary Arterial Hypertension and Risk Factors in End Stage Renal Disease Patients with Peritoneal Dialysis and Hemodialysis

Abstract

Background: Pulmonary arterial hypertension (PAH) is associated with high mortality and frequent complications in end stage renal disease patients. Epidemiological data for this disorder across the spectrum of end stage renal disease in Thai patients is limited. Objective: To compare the prevalence and risk factors of PAH in hemodialysis and peritoneal dialysis in end stage renal disease among the Thai patients. Materials and Methods: The authors retrospectively studied in patients with end stage renal disease at Pranangklao Hospital between January 2016 and December 2021. Results: A total of 201 patients were enrolled. The average age of patients was 55.57±16.22 years (47.3% male). Most patients had hypertension. Most patients had been prescribed folic acid. The number of patients with mean pulmonary artery pressure >20 mmHg was 81 (77.1%) in the hemodialysis group and 52 (54.2%) in the peritoneal dialysis group (p<0.001). PAH in hemodialysis was higher than peritoneal dialysis (OR 2.86, 95% CI 1.56 to 5.24, p<0.001). The following were factors associated with PAH: history of coronary artery disease (OR 2.77, 95% CI 1.29 to 5.94, p<0.009), history of beta-blocker use (OR 2.09, 95% CI 1.15 to 3.79, p<0.015), left ventricular ejection fraction by Simpson’s method (OR 0.95, 95% CI 0.92 to 0.98, p<0.001). The variable associated with PAH (peritoneal dialysis group) in multivariate logistic regression was Hemodialysis (adjusted OR 3.16, 95% CI 1.66 to 6.03, p<0.001). Conclusion: End stage renal disease in Thai patients undergoing hemodialysis carry a three-fold risk of pulmonary hypertension than peritoneal dialysis patients. Keywords: Pulmonary hypertension; Hemodialysis; Peritoneal dialysis