Pulmonary Hypertension in Chronic Kidney Disease

Alison Travers; Harrison W Farber; Mark J Sarnak

doi:10.1016/j.ccl.2021.04.004

Pulmonary Hypertension in Chronic Kidney Disease

Cardiol Clin. 2021 Aug;39(3):427-434. doi: 10.1016/j.ccl.2021.04.004.

Authors

Alison Travers¹, Harrison W Farber², Mark J Sarnak³

Affiliations

¹ Department of Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
² Department of Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA; Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, MA, USA.
³ Department of Medicine, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA; Division of Nephrology, Tufts Medical Center, Box 257, 800 Washington Street, Boston, MA 02111, USA. Electronic address: msarnak@tuftsmedicalcenter.org.

PMID: 34247755
DOI: 10.1016/j.ccl.2021.04.004

Abstract

There is a high prevalence of pulmonary hypertension in chronic kidney disease (CKD), with rates increasing as glomerular filtration rate declines. Pulmonary hypertension is associated with a higher risk of cardiovascular events and mortality in non-dialysis-dependent CKD stages 3 to 5, dialysis-dependent CKD, as well as kidney transplant recipients. The pathophysiology of pulmonary hypertension in CKD is multifactorial and includes higher pulmonary capillary wedge pressure caused by ischemic heart disease and cardiomyopathy, higher cardiac output caused by anemia and arteriovenous access used for hemodialysis, as well as potentially higher pulmonary vascular resistance. Treatment should focus on the underlying cause.

Keywords: Chronic kidney disease; Dialysis; Pulmonary hypertension; Risk factors.

Publication types

Review

MeSH terms

Glomerular Filtration Rate
Humans
Hypertension*
Hypertension, Pulmonary* / epidemiology
Hypertension, Pulmonary* / etiology
Hypertension, Pulmonary* / therapy
Prevalence
Renal Dialysis
Renal Insufficiency, Chronic* / complications
Renal Insufficiency, Chronic* / epidemiology