Pulmonary Hypertension is associated with mortality and cardiovascular events in chronic kidney disease patients
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Otros documentos de la autoría: Reque, Javier; García-Prieto, Ana; Linares, Tania; Vega, Almudena; Abad, Soraya; Panizo, Nayara; Quiroga, Borja; Collado-Boira, Eladio; López-Gómez, Juan Manuel
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http://dx.doi.org/10.1159/000453047 |
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Pulmonary Hypertension is associated with mortality and cardiovascular events in chronic kidney disease patientsAutoría
Fecha de publicación
2017-02Editor
Karger PublishersCita bibliográfica
REQUE, Javier, et al. Pulmonary Hypertension Is Associated with Mortality and Cardiovascular Events in Chronic Kidney Disease Patients. American Journal of Nephrology, 2016, vol. 45, no 2, p. 107-114.Tipo de documento
info:eu-repo/semantics/articleVersión de la editorial
http://www.karger.com/Article/Abstract/453047Versión
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Resumen
Background: We evaluated the prevalence, determinants and prognosis value of pulmonary hypertension (PH) in non-dialysis chronic kidney disease (CKD) patients. Methods: This is a prospective study with stages 3-5 ... [+]
Background: We evaluated the prevalence, determinants and prognosis value of pulmonary hypertension (PH) in non-dialysis chronic kidney disease (CKD) patients. Methods: This is a prospective study with stages 3-5 non-dialysis-dependent CKD patients. PH was estimated by Doppler echocardiography and defined as a pulmonary artery systolic pressure above 35 mm Hg. Results: Three hundred fifty-three patients were recruited, of whom 94 (26.6%) had PH. Prevalence of PH increased with the decline of renal function: 21.6, 24.1, and 31.7% in stages 3, 4, and 5, respectively. Independent predictors of PH were age, estimated glomerular filtration rate (eGFR), history of cardiovascular (CV) events, the presence of an arteriovenous fistulae (AVF), and left ventricular (systolic and diastolic) dysfunction. Over a median follow-up of 22 months, 71 patients died (20%). After multivariate adjustment for age, gender, previous CV disease, diastolic and systolic dysfunction, PH remained as an independent predictor of all-cause mortality (hazards ratio [HR] 1.84, 95% CI 1.06-3.18, p = 0.02). One hundred patients (28%) had a new onset CV event. After adjustment for age, gender, previous CV disease, systolic and diastolic dysfunction, PH maintains its independent association with CV events (HR 2.77, 95% CI 2.00-3.25, p < 0.001). Conclusions: PH prevalence rises as kidney function declines. Main determinants of PH are age, eGFR, previous CV disease, the presence of an AVF and left ventricular systolic or diastolic dysfunction. PH is an independent predictor of all-cause mortality and CV events. [-]
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Am J Nephrol 2017;45Derechos de acceso
© 2017 S. Karger AG, Basel
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