Risk factors of pulmonary hypertension and analysis of survival in hemodialysis patients
10.3760/cma.j.issn.1671-7368.2017.02.010
- VernacularTitle:血液透析患者肺动脉高压形成相关因素及生存分析
- Author:
Ziliang WANG
;
Jianyong LIU
;
Mingbo WANG
;
Yan XU
- Keywords:
Hypertension,pulmonary;
Renal dialysis;
Survival
- From:
Chinese Journal of General Practitioners
2017;16(2):132-136
- CountryChina
- Language:Chinese
-
Abstract:
One hundred and forty-two patients on maintenance hemodialysis were enrolled in the study.According to the guideline of American Society of Echocardiography 97 patients (68.3％) were classified as pulmonary artery hypertension [PAH,pulmonary artery systolic pressure (PASP) ＞ 35 mmHg (1 mmHg =0.133 kPa)] and 45 patients (31.7％) as non-PAH (PASP ≤ 35 mmHg).High sensitivity Creactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were measured by automatic analyzer and enzyme linked immunosorbent assay (ELISA),respectively.There were significant differences in CRP and TNF-α levels between PAH and non-PAH patients (P ＜ 0.05).Multivariate linear regression showed that TNF-α and interdialytic weight gain were positively correlated with PAH and left ventricular ejection fraction was negatively correlated with PAH (P ＜ 0.01).In the multivariate Cox proportional hazards models,PAH and TNF-α level were independently associated with higher risk for all-cause death (HR =1.06,95％ CI:1.03-1.09 and HR =1.31,95％ CI:1.17-1.46,respectively).In Kaplan-Meier survival analysis,the risk of all-cause mortality increased in parallel with PASP.The risk of death in patients with PASP ＞45 mmHg was higher than that in patients with PASP ≤45 mmHg (log-rank test:x2 =6.58,P =0.010),the risk was 2.82-fold (HR =2.82,95％ CI:1.38-5.77,P =0.004).
