The Effect of Improved Hemodialysis Adequacy on Primary Pulmonary Hypertension in End Stage Renal Disease Patients

Background: Hemodialysis serves as a vital life-support therapy that balances electrolytes and fluid levels while eliminating toxic substances from the body, thereby enabling patient survival. Enhanced dialysis efficacy is directly linked to a reduction in uremic complications and a decrease in mortality rates. Pulmonary hypertension (PH) represents a progressive condition stemming from cardiovascular, pulmonary, or systemic disorders, which is characterized by elevated morbidity and death risks. It is hypothesized that optimizing the quality of dialysis may mitigate PH. Consequently, this research was designed to assess how enhancing dialysis adequacy impacts pulmonary artery pressure (PAP) in hemodialysis patients residing in Shahroud.Methods: Employing a descriptive-analytic and longitudinal design, this study was carried out in ۲۰۲۳ at Imam Hossein Hospital, Shahroud, involving patients undergoing hemodialysis. Initially, an expert cardiologist utilized two-dimensional color Doppler echocardiography to determine systolic PAP. These measurements were taken the day following a dialysis session. Additionally, metrics regarding dialysis adequacy were documented for all participants. Subsequently, after a six-month interval during which specific interventions were implemented to boost dialysis adequacy, the patients underwent a repeat echocardiographic evaluation. The resulting PAP values were then analyzed and compared with the baseline data.Results: The study cohort comprised ۵۵ individuals, among whom ۳۷ achieved adequate dialysis levels, while ۱۸ were classified as receiving inadequate dialysis. The average age of the participants was ۵۶.۶۲±۱۶.۷۸ years, a figure that remained statistically consistent across the groups. In terms of gender distribution, the population included ۳۲ males (۵۸.۲%) and ۲۳ females (۴۱.۸%). The overall mean PAP was recorded at ۳۰±۱۳ mmHg. Specifically, ۲۸ subjects (۵۰.۹%) exhibited normal PAP levels, whereas the remaining ۲۷ (۴۹.۱%) presented with elevated pressure. At the baseline assessment, ۱۵ patients (۸۳.۳%) within the insufficient dialysis group demonstrated increased PAP. However, by the conclusion of the study—and following interventions to optimize dialysis adequacy—this number decreased to ۱۲ patients (۶۶.۷%), representing a statistically significant reduction (P-value=۰.۰۰۱).Conclusion: The findings indicate that enhancing the adequacy of dialysis leads to a substantial reduction in PAP and contributes to the improvement of the quality of life for patients undergoing hemodialysis.Background: Hemodialysis serves as a vital life-support therapy that balances electrolytes and fluid levels while eliminating toxic substances from the body, thereby enabling patient survival. Enhanced dialysis efficacy is directly linked to a reduction in uremic complications and a decrease in mortality rates. Pulmonary hypertension (PH) represents a progressive condition stemming from cardiovascular, pulmonary, or systemic disorders, which is characterized by elevated morbidity and death risks. It is hypothesized that optimizing the quality of dialysis may mitigate PH. Consequently, this research was designed to assess how enhancing dialysis adequacy impacts pulmonary artery pressure (PAP) in hemodialysis patients residing in Shahroud. Methods: Employing a descriptive-analytic and longitudinal design, this study was carried out in ۲۰۲۳ at Imam Hossein Hospital, Shahroud, involving patients undergoing hemodialysis. Initially, an expert cardiologist utilized two-dimensional color Doppler echocardiography to determine systolic PAP. These measurements were taken the day following a dialysis session. Additionally, metrics regarding dialysis adequacy were documented for all participants. Subsequently, after a six-month interval during which specific interventions were implemented to boost dialysis adequacy, the patients underwent a repeat echocardiographic evaluation. The resulting PAP values were then analyzed and compared with the baseline data. Results: The study cohort comprised ۵۵ individuals, among whom ۳۷ achieved adequate dialysis levels, while ۱۸ were classified as receiving inadequate dialysis. The average age of the participants was ۵۶.۶۲±۱۶.۷۸ years, a figure that remained statistically consistent across the groups. In terms of gender distribution, the population included ۳۲ males (۵۸.۲%) and ۲۳ females (۴۱.۸%). The overall mean PAP was recorded at ۳۰±۱۳ mmHg. Specifically, ۲۸ subjects (۵۰.۹%) exhibited normal PAP levels, whereas the remaining ۲۷ (۴۹.۱%) presented with elevated pressure. At the baseline assessment, ۱۵ patients (۸۳.۳%) within the insufficient dialysis group demonstrated increased PAP. However, by the conclusion of the study—and following interventions to optimize dialysis adequacy—this number decreased to ۱۲ patients (۶۶.۷%), representing a statistically significant reduction (P-value=۰.۰۰۱). Conclusion: The findings indicate that enhancing the adequacy of dialysis leads to a substantial reduction in PAP and contributes to the improvement of the quality of life for patients undergoing hemodialysis.

کلیدواژه ها:

Hemodialysis ، Pulmonary hypertension ، Dialysis adequacy