Idiopathic Pre-capillary Pulmonary Hypertension in ESKD Patients

Idiopathic Pre-capillary Pulmonary Hypertension in Patients With End-stage Kidney Disease

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02743091

Enrollment

1988

Registered

2016-04-19

Start date

2001-01-31

Completion date

2015-12-31

Last updated

2016-04-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pulmonary Hypertension

Keywords

heart failure, survival, end-stage kidney disease

Brief summary

This study investigates the prevalence and prognosis of idiopathic pre-capillary pulmonary hypertension (PH) in patients with end-stage kidney disease (ESKD).

Detailed description

Pulmonary hypertension (PH) is a rare cardiovascular disease with progressive and fatal features. PH is classified into the 5 groups, and the prevalence of group 1 pulmonary arterial hypertension, including idiopathic and heritable, is 5 to 15 cases per one million adults and a median survival was reportedly three years. PH found in patients with end-stage kidney disease (ESKD) is classified into group 5, because the pathogenesis and clinical characteristics have not been clarified. The prevalence of PH in patients with ESKD was reportedly around 17\ 56% based on echocardiographic studies. In this study, we evaluated the incidence of idiopathic pre-capillary PH of ESKD patients by right heart catheterization, and examined the prognosis by following the occurrence of heart failure death.

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

50 Years to 85 Years

Healthy volunteers

Inclusion criteria

* Symptoms of dyspnea, hypotension (systolic blood pressure \<90mmHg, or syncope. * Systolic pressure gradients in tricuspid valve of 40 mmHg or more. * In right heart catheterization, precapillary PH was defined as mean pulmonary arterial pressure (PAP) ≥25 mmHg, pulmonary vascular resistance (PVR) ≥3 wood unit, and pulmonary artery wedge pressure (PAWP) ≤15 mmHg.

Exclusion criteria

* Patients with systolic left ventricular dysfunction (left ventricular ejection fraction \[LVEF\] \<50%), mitral or aortic regurgitation of grade 2 or more, aortic or mitral surface \<1.5 cm2, severe anemia (blood hemoglobin \<9 g/dl), severe chronic obstructive pulmonary disease defined by percent predicted forced expiratory volume in one second \<60%, or lung fibrosis were not enrolled in this study. * In right hear catheterization, PAP ≥25 mmHg and PAWP \>15 mmHg were diagnosed as post capillary PH.

Design outcomes

Primary

Measure	Time frame
Number of patients of idiopathic pre-capillary hypertension	14 years

Secondary

Measure	Time frame
Number of patients who died of heart failure	14 years

Outcome results