Echocardiographic assessment of pulmonary hypertension in patients with chronic kidney disease seen at the Jos University Teaching Hospital

Abstract

Background: Pulmonary hypertension (PH) is common in patients with chronic kidney disease (CKD) and is an independent predictor of mortality. It is a major public health issue that can lead to renal failure, heart disease, and early mortality. This study aims to assess the prevalence of pulmonary hypertension in patients with chronic kidney disease seen at JUTH.
Methods: A hospital-based cross-sectional study was conducted where 69 CKD patients were selected using a convenience sampling technique. The mean pulmonary arterial pressure (mPAP) of CKD patients was determined using transthoracic echocardiography. Chi-square and ANOVA were used to test for a significant difference in the prevalence of PH in different stages of CKD and levels of PAP based on severity in CKD patients respectively.
Results: Out of the 69 participants, 18 (26.1%) had elevated mPAP that was >24mmHg, of which 16 (23.3%) were mildly elevated with an mPAP of 29.6 mmHg, 1(1.4%) were moderately elevated with mPAP of 46.0 mmHg, and 1(1.4%) also had severely elevated PAP with a mean value of 58.0 mmHg. Most of the CKD patients were in stage 5 – 13(18.8%) while a few were in stage 2 and stage 3 representing 1 (1.4%) each.
Conclusion: Patients with CKD frequently experience pulmonary hypertension, and this rises as renal failure worsens. Therefore, echocardiography is advised for assessing pulmonary pressures in CKD patients in stage 3 and above, and for subsequent monitoring of the disease progression and response to treatment.