End Stage Renal Disease-Associated Pulmonary Hypertension
Epidemiology
Pulonary hypertension has been reported to occur in ESRD on chronic (long-term) HD
Physiology
Potential Mechanisms of Pulmonary Hypertension
Hormonal and metabolic derangement associated with ESRD might lead to pulmonary vascular constriction
High cardiac output (resulting from the arteriovenous access itself and often concomitant anemia)
Fluid overload
Diastolic and systolic left heart dysfunction
Clinical Presentation
Pulmonary Hypertension (see Pulmonary Hypertension, [[Pulmonary Hypertension]]): present in approximately 40% of ESRD patients on chronic HD (when assessed by Echo)
References
Yigla M, Nakhoul F, Sabag A, et al. Pulmonary hypertension in patients with end-stage renal disease. Chest 2003;123:1577–82
Nakhoul F, Yigla M, Gilman R, Reisner SA, Abassi Z. The pathogenesis of pulmonary hypertension in haemodialysis patients via arterio-venous access. Nephrol Dial Transplant 2005;20:1686 –92