Abstract: TH-PO202
Is Pulmonary Hypertension (PH) Associated with the Type of Hemodialysis Access and Is PH a Barrier to Kidney Transplant?
Session Information
- Hypertension and CVD: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Jahngir, Muhammad Umair, Temple University, Philadelphia, Pennsylvania, United States
- De Antonis, Christine, Temple University, Philadelphia, Pennsylvania, United States
- Gillespie, Avrum, Temple University, Philadelphia, Pennsylvania, United States
Background
In hemodialysis (HD) patients, PH is multifactorial. Surgically created arterio-venous (AV) fistulas/grafts may contribute to PH by increasing right ventricular preload. We compared the prevalence of PH among patients with AV accesses to those with hemodialysis central venous catheters (CVC). We then examined whether PH was a contraindication to kidney transplantation.
Methods
A single-center 10-year retrospective cross-sectional study of right heart catheterizations (RHC) in randomly selected HD patients, were identified with the CPT codes: 93451 and ICD10 Z99.2. Patients with a previous solid organ transplantation or advanced heart failure requiring inotropic or mechanical support were excluded. Categorical variables were compared with Fisher’s exact tests and continuous variables were compared with t-tests.
Results
3834 charts were extracted, 257 were reviewed, and 107 were included. 65% were male and 63% had diabetic renal disease. The median dialysis vintage was 26 months (IQR:61.8months). 64.5% patients had mean pulmonary arterial pressure of >20mmHg, 43% had pulmonary capillary wedge pressure ≥15mmHg, and 22% had pulmonary vascular resistance of ≥3.00. The type of HD access was not associated with PH (47%CVC vs 41%AV, p=0.65). Among 26% patients with vascular duplex, there was no difference between AV access flow rates in those with and without PH (median(IQR):1483(2139) vs 1267(2092),p=0.29). 86% survived after 1-year of RH and mortality was not associated with prevalance of PH. There was no difference in transplant candidacy between those with and without PH (81% vs 75%,p=0.47).
Conclusion
PH was common in HD patients (42%), and the type of vascular access was not associated with PH between. Diagnosis of PH had no direct effect on transplant candidacy.