Kidney Disease Patients with Pulmonary Hypertension Face Poorer Outcomes, Study Finds

Many people with chronic kidney disease also have pulmonary hypertension, a condition that increases their risk of heart problems and death, a review of 16 studies found.

Doctors refer to health problems that can damage the heart muscle as cardiovascular events. They include a heart attack, an irregular heartbeat, or a blood clot in the heart or lungs.

Researchers reported on their review in the American Journal of Kidney Disease. The article was titled “Pulmonary Hypertension, Mortality, and Cardiovascular Disease in CKD and ESRD Patients: A Systematic Review
and Meta-analysis.”

The 16 studies that the review covered involved 7,112 people with chronic kidney disease or end-stage renal disease. An end-stage disease means a patient needs dialysis or a kidney transplant.

Researchers’ major goal was to look for links between pulmonary hypertension and chronic kidney disease.

They discovered that 23 percent of the patients had pulmonary hypertension.

The risk of death from any cause was 1.44 times higher in chronic kidney disease patients who also had pulmonary hypertension than in patients with kidney disease only, they found. The risk was 2.32 times higher in end-stage renal disease patients on dialysis who had pulmonary hypertension. And it was 2.08 times higher in end-stage renal disease patients with a functioning kidney transplant.

Another finding was that chronic kidney patients’ risk of a cardiovascular event was 1.67 times higher if they had pulmonary hypertension. It was 2.33 times higher if they had an end-stage renal disease and were on dialysis.

In addition, the risk of death from a cardiovascular event was 2.20 times higher in patients with chronic kidney disease or end-stage renal disease and pulmonary hypertension.

The team concluded that patients with decreased kidney function and pulmonary hypertension faced poorer outcomes. They called for studies on whether pulmonary hypertension treatments can affect these patients’ death rates.

The fact that “pulmonary hypertension is robustly associated with adverse outcomes in patients” with chronic kidney disease and end-stage renal disease “implies that improved diagnosis and management of pulmonary hypertension may lead to improved outcomes among such patients,” the researchers wrote.

“Pulmonary hypertension is consistently associated with adverse outcomes, including all-cause mortality and cardiovascular events, in patients with advanced kidney disease,” they wrote. “Ultimately, randomized studies are needed to determine whether pulmonary hypertension treatments in patients with decreased kidney function can improve the excess mortality burden associated with the coexistence of these conditions.”