Document Detail

Systemic inflammation is associated with pulmonary hypertension in patients undergoing haemodialysis.
MedLine Citation:
PMID:  19164324     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pulmonary hypertension (PH) is an overlooked cardiovascular morbidity in patients undergoing haemodialysis. Inflammation has been demonstrated to play a significant role with certain types of PH in non-uraemic patients, but studies analysing the mechanisms in dialyzed patients with PH are rare. Hence, we investigated systemic and local inflammation biomarkers associated with PH in uraemia patients to elucidate the potential mechanism. METHODS: A cross-sectional study was conducted in which 97 haemodialysis patients were initially evaluated in our hospital. Twelve inflammatory cytokines were measured using a cytometric beads assay in patients with and without PH. FE(NO) (fractional exhaled nitric oxide) was checked by a chemiluminescence analyser in patients with and without PH as well as by normal controls. RESULTS: Thirty-nine eligible patients were enrolled. Compared to patients without PH (group A), patients with PH (group B) had significantly higher serum levels of hs-CRP, IL-1beta, TNF-alpha and IL-6. FE(NO) was also measured. Though the pre-dialysis FE(NO) levels were elevated in both groups; group B patients had significantly higher pre-dialysis FE(NO) levels than group A patients (39.9 +/- 16.7 versus 31.8 +/- 10.3, P = 0.045). The post-dialysis FE(NO) levels returned to normal in group A while the remaining were significantly higher in group B (30.3 +/- 10.3 versus 20.1 +/- 10.9, P = 0.003). CONCLUSIONS: Our study revealed that dialyzed patients with PH had a significantly higher level of airway FE(NO) as well as serum levels of acute phase reactive protein and cytokines, including IL-1beta, TNF-alpha and IL-6. A chronic inflammation might play an important role in the pathogenesis of PH in patients undergoing haemodialysis.
Tung-Min Yu; Yi-Hsing Chen; Jeng-Yuan Hsu; Chung-Shu Sun; Ya-Wen Chuang; Cheng-Hsu Chen; Ming-Ju Wu; Chi-Hung Cheng; Kuo-Hsiung Shu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-01-22
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  24     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1946-51     Citation Subset:  IM    
Division of Nephrology, Department of Internal Medicine,Taichung Veterans General Hospital, Taiwan.
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MeSH Terms
Arteriovenous Shunt, Surgical
Blood Flow Velocity
C-Reactive Protein / metabolism
Cross-Sectional Studies
Cytokines / blood
Hypertension, Pulmonary / blood,  etiology*
Inflammation / blood,  etiology*
Inflammation Mediators / blood
Middle Aged
Renal Dialysis / adverse effects*
Uremia / blood,  complications*,  physiopathology,  therapy*
Reg. No./Substance:
0/Cytokines; 0/Inflammation Mediators; 9007-41-4/C-Reactive Protein

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