Publication:

Outcome of pulmonary hypertension in patient on dialysis following kidney transplantation: an observational study

Background Pulmonary hypertension (PH) is common among patients with end stage renal disease (ESRD) who are on dialysis and PH is associated with higher mortality rates among these patients. The impact of kidney transplantation on pulmonary hypertension is unknown. The purpose of this study is to evaluate the impact of successful kidney transplantation on pulmonary arterial hypertension in these patients on dialysis.

Methods The study was conducted on patients who underwent kidney transplantation in Department of Nephrology PSGIMSR. Patients with pulmonary hypertension pre transplant were taken up for the study after the application of inclusion and exclusion criteria and after obtaining consent. Demographic, clinical information and laboratory results were collected. The assessment of PH was done by Doppler echocardiography pre transplant and   3 and 6 months after transplant during follow up.

Results The prevalence of PH was 40%. The mean age of study population was 42 ± 8.7 years. The mean dialysis duration of study population was 32±8 months. 54.5% were male. 45.5% were female. Out of the 55 transplant recipients, 22 patients had elevated PASP on preoperative echocardiography examination.  Compared to pre-transplant values, a significant decrease was observed in mean SPAP values and the severity of pulmonary hypertension 3 and6 months postoperative follow up (p<0.003).

Conclusions The prevalence of pre-operative PH among dialysis patient was high. Kidney transplantation leads to considerable improvement in pulmonary arterial hypertension in patients on dialysis.