Document Detail

Pulmonary hypertension in hemodialysis patients: an unrecognized threat.
MedLine Citation:
PMID:  16970730     Owner:  NLM     Status:  MEDLINE    
Pulmonary hypertension (PH) is a progressive, fatal pulmonary circulatory disease that accompanies many conditions (including left to right side shunt) with compensatory elevated cardiac output. PH also complicates chronic hemodialysis (HD) therapy immediately after the creation of an arteriovenous (AV) access, even before starting HD therapy. It tends to regress after temporary AV access closure and after successful kidney transplantation. Affected patients have significantly higher cardiac output. This syndrome is associated with a statistically significant survival disadvantage. The laboratory hallmark of this syndrome is reduced basal and stimulatory nitric oxide (NO) levels. It appears that patients with end-stage renal disease (ESRD) acquire endothelial dysfunction that reduces the ability of their pulmonary vessels to accommodate the AV access-mediated elevated cardiac output, exacerbating the PH. Doppler echocardiographic screening of ESRD patients scheduled for HD therapy for the occurrence of PH is indicated. Early diagnosis enables timely intervention, currently limited to changing dialysis modality or referring for kidney transplantation.
Mordechai Yigla; Zaid Abassi; Shimon A Reisner; Farid Nakhoul
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in dialysis     Volume:  19     ISSN:  0894-0959     ISO Abbreviation:  Semin Dial     Publication Date:    2006 Sep-Oct
Date Detail:
Created Date:  2006-09-14     Completed Date:  2007-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-7     Citation Subset:  IM    
Division of Pulmonary Medicine and Department of Physiology, Rambam Medical Center, and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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MeSH Terms
Arteriovenous Shunt, Surgical / adverse effects
Cardiac Output, High / physiopathology
Endothelium, Vascular / physiopathology
Hypertension, Pulmonary / mortality,  physiopathology*,  therapy
Kidney Failure, Chronic / mortality,  physiopathology*,  therapy
Renal Dialysis / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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