The Relationship of Fluid Overload as Assessed by Bioelectrical Impedance Analysis with Pulmonary Arterial Hypertension in Hemodialysis Patients
Süreyya Yılmaz, Yasar Yildirim, Mahsuk Taylan, Melike Demir, Zülfükar Yilmaz, Ali Veysel Kara, Fatma Aydin, Hadice Selimoglu Sen, Aziz Karabulut, Fusun Topcu
(Department of Chest Diseases and Tuberculosis, Dicle University, Faculty of Medicine, Diyarbakir, Turkey)
Med Sci Monit 2016; 22:488-494
Pulmonary arterial hypertension (PAH) is common disease among hemodialysis (HD) patients and is associated with increased morbidity and mortality. However, its pathogenesis has not been completely elucidated. We aimed to evaluate the frequency of PAH in HD patients, as well as the relationship between fluid status and PAH.
MATERIAL AND METHODS: We enrolled 77 HD patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status. BIA was performed before and 30 min after the midweek of HD. Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was deﬁned as OH/ECW ≥7%. Echocardiographic examinations were performed before and after the HD. Pulmonary arterial hypertension was defined as systolic pulmonary artery pressure at rest (sPAP) higher than 35 mmHg.
RESULTS: PAH was found in 33.7% of the HD patients. OH/ECW and the frequency of fluid overload were significantly higher in HD patients with PAH than those without PAH, whereas serum albumin and hemoglobin levels were significantly lower. sPAP level was significantly higher in HD patients with fluid overload than in those without fluid overload after hemodialysis session. Furthermore, sPAP, OH/ECW levels, and the frequency of PAH were significantly reduced after HD. We also found a significant positive correlation between sPAP and OH/ECW. Multivariate logistic regression analysis demonstrated fluid overload to be an independent predictor of PAH after HD.
CONCLUSIONS: PAH is prevalent among HD patients. This study demonstrated a strong relationship between fluid overload and PAH in HD pati... read more
Keywords: Electric Impedance, Pulmonary Heart Disease, Renal Dialysis