Comparison of pulmonary arterial pressure in patients under chronic hemodialysis with and without arteriovenous fistula

BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive disorder and a newly-discovered disease in people with end stage renal disease (ESRD). In patients who are hemodialyzed through arteriovenous fistula (AVF), the incidence of pulmonary hypertension (PHT) is highly probable. Regarding the main role of the AVF in the pathogenesis of PAH and the fact that AVF is the main method of vascular access in patients undergoing dialysis, we decided to investigate pulmonary artery pressure (PAP) in patients under chronic hemodialysis. METHODS: This was a cross-sectional study. All patients with chronic hemodialysis were divided into two groups according to the status of the fistula. The number of cases examined included 100 patients and data were analyzed by SPSS software. RESULTS: The most common cause of ESRD was hypertension (HTN) followed by diabetes mellitus (DM), polycystic kidney disease (PKD), urologic disorders, DM and HTN, combined blood pressure (BP) and PKD, renal stones, and other items ultimately. The average creatinine level was 8.59 mg/dl. Therefore, the mean creatinine level of patients, although relative to mode and median, was in any case significantly higher than the mean, which was predictable according to the ESRD community studied. The mean phosphate level was 5.66 mg/dl, and the mean hemoglobin (Hb) was 11.56 g/dl. The mean parathyroid hormone (PTH) and PAP were 558.68 and 27.33 mmHg, respectively, and the mean of ejection fraction (EF) was 50.75%. There was a significant difference between the mean PAP in the two groups (P = 0.048), as it was higher in the AVF group. CONCLUSION: Results of this study showed that AVF and ESRD both were risk factors for high PAP and PHT.