Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients

Nasri, H.;
Next Document Rev Port Pneumol. 2013;19:238-9

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Dear Editor,

We read with great interest the nice article by Etemadi and colleagues, in your journal, Revista Portuguesa de Pneumologia, entitled “Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients”.1 In a retrospective study of chronic hemodialysis and peritoneal dialysis patients, pulmonary hypertension was found in 14 (41.1%) patients of the hemodialysis group and in 6 (18.7%) patients of the peritoneal dialysis group, where pulmonary hypertension was defined as a systolic pulmonary artery pressure (SPAP) ≥ 35 mmHg. They concluded that unexplained pulmonary hypertension seems to be more frequent in patients undergoing hemodialysis than with patients in the peritoneal dialysis group. In this context, I would like to make a few points about pulmonary hypertension in dialysis patients. In a study of 102 maintenance hemodialysis patients, we found pulmonary artery pressure of 41.5 ± 12.6 mmHg. In our study, 76.5% of hemodialysis patients had SPAP = 35 mmHg. In this study we can also see that pulmonary artery pressure had significant positive correlation with the duration and degree of hemodialysis.2 In another study we also observed that pulmonary artery pressure had significant positive correlation with serum intact parathormone.3 Pulmonary arterial hypertension is a serious cardiac complication among patients with end-stage kidney disease, especially patients on hemodialysis as mentioned in the study by Etemadi et al., and we need to look for other aggravating factors among dialysis patients.3, 4, 5 In order to achieve better understanding about this aspect of dialysis patients, more clinical studies are suggested.

Ethical disclosures Protection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that no patient data appear in this article.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Conflicts of interest

The author has no conflicts of interest to declare.

Bibliography

1.Etemadi J, Zolfaghari H, Firoozi R, Ardalan MR, Toufan M, Shoja MM, et-al. Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients. Rev Port Pneumol. 2012;18:10-4.
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2.Nasri H, Shirani Sh, Baradaran A. Pulmonary artery pressure in maintenance hemodialysis patients. Pak J Biol Sci. 2006;9:107-10.
3.Nasri H. Pulmonary artery pressure in association with serum parathormone in maintenance hemodialysis patients. Arch Med Sci. 2006;2:32-5.
4.Gheissari A, Hemmatzadeh S, Merrikhi A, Fadaei-Tehrani S, Madihi Y. Chronic kidney disease in children: a report from a tertiary care center over 11 years. J Nephropathol. 2012;1:177-82.
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5.Gheissari A, Mehrasa P, Merrikhi A, Madihi Y. Acute kidney injury: a pediatric experience over 10 years at a tertiary care center. J Nephropathol. 2012;1:101-8.
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H. Nasri a, ,

a Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran