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2270557 
Journal Article 
Pulmonary Hypertension in CKD 
Bolignano, D; Rastelli, S; Agarwal, R; Fliser, D; Massy, Z; Ortiz, A; Wiecek, A; Martinez-Castelao, A; Covic, A; Goldsmith, D; Suleymanlar, G; Lindholm, B; Parati, G; Sicari, R; Gargani, L; Mallamaci, F; London, G; Zoccali, C 
2013 
Yes 
American Journal of Kidney Diseases
ISSN: 0272-6386
EISSN: 1523-6838 
61 
4 
612-622 
23164943 
WOS:000317274900355 
Pulmonary arterial hypertension is a rare disease often associated with positive antinuclear antibody and high mortality. Pulmonary hypertension, which rarely is severe, occurs frequently in patients with chronic kidney disease (CKD). The prevalence of pulmonary hypertension ranges from 9%-39% in individuals with stage 5 CKD, 18.8%-68.8% in hemodialysis patients, and 0%-42% in patients on peritoneal dialysis therapy. No epidemiologic data are available yet for earlier stages of CKD. Pulmonary hypertension in patients with CKD may be induced and/or aggravated by left ventricular disorders and risk factors typical of CKD, including volume overload, an arteriovenous fistula, sleep-disordered breathing, exposure to dialysis membranes, endothelial dysfunction, vascular calcification and stiffening, and severe anemia. No specific intervention trial aimed at reducing pulmonary hypertension in patients with CKD has been performed to date. Correcting volume overload and treating left ventricular disorders are factors of paramount importance for relieving pulmonary hypertension in patients with CKD. Preventing pulmonary hypertension in this population is crucial because even kidney transplantation may not reverse the high mortality associated with established pulmonary hypertension. Am J Kidney Dis. 61(4): 612-622. (C) 2013 by the National Kidney Foundation, Inc. 
Pulmonary hypertension; chronic kidney disease; hemodialysis; peritoneal dialysis