Prevalence and risk factors for pulmonary arterial hypertension in end-stage renal disease patients undergoing continuous ambulatory peritoneal dialysis

Figures & data

Table 1. Comparison in general data between the PAH group and the non-PAH group.

General data	PAH (n = 65)	Non-PAH (n = 112)	t/χ^2	p
Age	56.29 ± 15.27	54.15 ± 13.91	0.952	0.343
Gender (male/female)	31/34	54/58	0.004	0.947
Dialysis time (month)	36.92 ± 14.55	35.81 ± 12.94	0.523	0.600
BMI (kg/m^2)	21.43 ± 2.26	21.28 ± 2.85	0.397	0.708
IDWG (kg)	2.43 ± 0.75	2.14 ± 0.97	2.075	0.039
Pre-dialysis SBP (mmHg)	142.12 ± 10.56	138.24 ± 6.35	3.055	0.003
Pre-dialysis DBP (mmHg)	92.20 ± 13.34	84.25 ± 13.17	3.853	<0.001
MAP (mmHg)	108.84 ± 8.72	102.25 ± 9.22	4.678	<0.001
Erythropoietin dosage (10,000 u/week)	1.02 ± 0.31	0.96 ± 0.29	1.277	0.203
ESRD protopathy (n, %)
Chronic glomerulonephritis	20 (11.30%)	45 (25.42%)	0.226	0.635
Diabetic nephropathy	12 (29.23%)	23 (14.29)	0.112	0.738
Hypertensive nephropathy	28 (43.08%)	30 (26.79%)	4.955	0.026
Other diseases	5 (9.23%)	14 (11.61%)	0.992	0.319
PASP	44.45 ± 6.39	26.35 ± 4.37	22.32	<0.001

Notes: PAH, pulmonary arterial hypertension; BMI, body mass index; IDWG, interdialytic weight gain; SBP, systolic blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; ESRD, end-stage renal disease; PASP, pulmonary arterial systolic pressure.

Table 2. Comparison in biochemical indicators between the PAH group and the non-PAH group.

Biochemical indicators	PAH (n = 65)	Non-PAH (n = 112)	t/χ^2	p
Scr (umol/L)	603.51 ± 113.12	626.39 ± 141.32	1.114	0.267
BUN (mmol/L)	24.26 ± 7.25	25.15 ± 8.04	0.736	0.463
Hb (g/L)	110.34 ± 10.47	116.82 ± 17.25	2.747	0.007
Hct (%)	34.97 ± 9.23	36.25 ± 3.57	1.310	0.192
ALB (g/L)	29.16 ± 14.28	35.57 ± 17.23	2.535	0.012
PA (g/L)	0.30 ± 0.06	0.32 ± 0.05	2.401	0.017
ALP (mmol/L)	127.60 ± 19.55	122.42 ± 48.13	0.828	0.409
TC (mmol/L)	3.80 ± 1.12	3.58 ± 1.09	1.282	0.202
TG (mmol/L)	1.49 ± 0.76	1.65 ± 0.34	1.766	0.080
LDL-C (mmol/L)	2.26 ± 0.75	2.07 ± 0.63	1.807	0.073
HDL-C (mmol/L)	1.16 ± 0.61	1.07 ± 0.07	1.551	0.123
KT/V	1.45 ± 0.42	1.38 ± 0.31	1.277	0.203
CRP-positive rate (n, %)	27 (41.54%)	19 (16.96%)	12.91	<0.001
Ca (mmol/L)	2.19 ± 0.38	2.27 ± 0.24	1.720	0.087
P (mmoI/L)	2.03 ± 0.28	1.97 ± 0.32	1.259	0.210
iPTH (ng/mL)	325.23 ± 113.05	315.14 ± 121.45	0.546	0.586
NT-proBNP (ng/L)	348.03 ± 24.15	322.12 ± 32.51	5.590	<0.001

Notes: PAH, pulmonary arterial hypertension; SCr, serum creatinine; BUN, blood urea nitrogen; Hb, hemoglobin; Hct, hematocrit; ALB, serum albumin; PA, prealbumin; ALP, alkaline phosphatase; TC, total cholesterol; TG, triglyceride; LDL-C, low density lipoprotein-cholesterol; HDL-C, high density lipoprotein-cholesterol; KT/V, urea clearance index; CRP, C-reactive protein; Ca, blood calcium; P, serum phosphorus; PTH, parathyroid hormone; NT-proBNP, N-terminal pro-brain natriuretic peptide.

Table 3. Comparison in echocardiographic parameters between the PAH group and the non-PAH group.

Echocardiographic parameters	PAH (n = 65)	Non-PAH (n = 112)	t/χ^2	p
RVID (mm)	21.21 ± 2.45	20.25 ± 2.07	2.778	0.006
RVOTD (mm)	32.54 ± 4.15	30.45 ± 3.02	3.855	<0.001
MPAD (mm)	24.43 ± 3.07	23.27 ± 2.32	3.951	0.005
LAD (mm)	41.86 ± 4.06	40.07 ± 3.75	2.970	0.003
LVOTD (mm)	27.14 ± 3.12	26.21 ± 3.41	1.803	0.073
ARD (mm)	31.08 ± 3.32	30.15 ± 3.21	1.834	0.068
LVEDD (mm)	49.41 ± 9.49	43.23 ± 5.24	2.101	0.037
LVESD (mm)	34.02 ± 4.12	32.35 ± 7.13	0.901	0.369
LVESV (mL)	99.02 ± 17.27	93.13 ± 22.57	1.817	0.071
LVEDV (mL)	37.42 ± 13.14	34.47 ± 12.63	1.476	0.142
SV (mL)	57.01 ± 8.42	55.76 ± 6.46	1.108	0.270
CO (L)	4.53 ± 1.64	4.33 ± 1.30	0.894	0.373
CI (L/m^2)	2.45 ± 0.79	2.32 ± 0.43	1.415	0.159
LVEF (%)	52.59 ± 5.93	61.36 ± 7.84	7.810	<0.001
PE (%)	8.01 ± 1.19	7.90 ± 0.70	0.782	0.435
IVST (mm)	12.09 ± 2.76	11.19 ± 1.37	2.896	0.004
LVMI	162.78 ± 61.16	135.30 ± 53.41	3.126	0.002
TAPSE	13.56 ± 3.81	17.10 ± 2.70	7.207	<0.001
E/A (n, %)			7.321	0.007
>1	27 (15.25%)	25 (14.12%)
<1	38 (21.47%)	87 (49.15%)
E/E’	14. 03 ± 3.12	16.27 ± 5.03	3.244	0.001
Valve calcification (n, %)			6.359	0.012
Calcification	34 (20.90%)	37 (19.21%)
Non-calcification	31 (17.51%)	75 (42.37%)

Notes: PAH, pulmonary arterial hypertension, RVID, right ventricular internal diameter; RVOTD, right ventricular outflow tract diameter; MPAD, main pulmonary artery diameter; LAD, left atrial diameter; LVOTD, left ventricular outflow tract diameter; ARD, aortic root diameter; LVEDD, left ventricular end-diastolic diameter; LVESD, left ventricular end-systolic diameter; LVESV, left ventricular end systolic volume; LVEDV, left ventricular end-diastolic volume; SV, stroke volume; CO, cardiac output; CI, cardiac index; LVEF, left ventricular ejection fraction; PE, pericardial effusion; IVST, interventricular septal thickness; LVMI, left ventricular mass index; TAPSE, tricuspid annulus plane systolic excursion; E/A, the ratio of early diastolic transmitral inflow velocity to early diastolic mitral annulus velocity; E/E’, the ratio of mitral early diastolic blood flow peak and mitral annulus velocity.

Table 4. Logistic regression analysis of risk factors associated with PAH in ESRD patients undergoing CAPD.

Variables	Regression coefficient	Standard error	Wald	p	OR	95%CI
DBP	0.075	0.036	4.219	0.040	1.078	1.003	1.157
ALB	−0.096	0.037	6.777	0.009	0.908	0.845	0.977
NT-proBNP	0.063	0.018	11.790	0.001	1.066	1.028	1.105
RVID	0.572	0.237	5.837	0.016	1.771	1.114	2.816
RVOTD	0.322	0.139	5.384	0.020	1.380	1.051	1.812
LAD	0.560	0.167	11.184	0.001	1.751	1.261	2.431
LVEF	−0.326	0.102	10.227	0.001	0.722	0.591	0.882
TAPSE	−7.355	0.229	10.278	0.001	0.479	0.306	0.751
E/E’	−2.895	0.120	5.842	0.016	0.749	0.592	0.947

Notes: PAH, pulmonary arterial hypertension; ESRD, end-stage renal disease; CAPD, continuous ambulatory peritoneal dialysis; DBP, diastolic blood pressure; ALB, serum albumin; NT-proBNP, N-terminal of pro-hormone brain natriuretic peptide; RVID, right ventricular internal diameter; RVOTD, right ventricular outflow tract diameter; LAD, left atrial diameter; LVEF, left ventricular ejection fraction; TAPSE, tricuspid annulus plane systolic excursion; E/E’, the ratio of mitral early diastolic blood flow peak and mitral annulus velocity.