Prevalence, Pathogenesis, and Prognosis of Pulmonary Hypertension in Dialysis Patients

Prevalence, Pathogenesis, and Prognosis of Pulmonary Hypertension in Dialysis Patients

This prospective multicenter longitudinal study aims to investigate the prevalence, pathogenesis, and prognosis of pulmonary hypertension in patients with end-stage renal disease undergoing chronic hemodialysis. The research seeks to identify specific clinical factors and biomarkers like angiopoietin-2 that contribute to the development of this condition, while evaluating the prognostic value of right ventricular function measured via TAPSE. Participants undergo a standardized screening echocardiogram the day after their intermediate dialysis session to determine the probability of pulmonary hypertension. Those identified as high-risk receive further diagnostic confirmation through right heart catheterization, respiratory function tests, and lung scans to clarify the underlying etiology. The protocol also evaluates the hemodynamic impact of high-flow arteriovenous fistulas and volume overload on pulmonary pressures. Clinical follow-up is conducted at baseline and subsequently at 6, 12, and 24 months to monitor patient outcomes and standardize therapeutic management according to established European guidelines.

Inclusion Criteria:

• Patients aged between 18 and 75 years
• Patients on stable extracorporeal hemodialysis for at least 6 months
• Dialysis frequency of two or three times per week
• Ability to provide written informed consent

Exclusion Criteria:

• WHO functional class IV
• Presence of valvular or congenital heart disease
• Acute infections within the month preceding the cardiological evaluation