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Case Reports
. 2024 Sep 19;12(9):e70027.
doi: 10.1002/rcr2.70027. eCollection 2024 Sep.

Pulmonary vasodilators in patients with advanced chronic kidney disease and pre-capillary pulmonary hypertension-A case series

Raul Leguizamon  1 , Ian McLaren  1 , Tara John  1 , Rasha Khan  1 , Alexander Prendergast  1 , Phuuwadith Wattanachayakul  1 , Andrew Geller  1 , John Malin  1 , Simone A Jarret  1 , Kevin Bryan Lo  2 , Jose Manuel Martinez Manzano  3 , Christian Witzke  4
Affiliations
Case Reports

Pulmonary vasodilators in patients with advanced chronic kidney disease and pre-capillary pulmonary hypertension-A case series

Raul Leguizamon et al. Respirol Case Rep. .

Abstract

Pulmonary hypertension (PH) is a prevalent complication among patients with chronic kidney disease (CKD). In these patients, pulmonary vasodilators may be useful but are underused. We describe a group of patients with precapillary PH and advanced CKD treated with pulmonary vasodilators. This was a case series of patients with CKD stage 4 and 5 and precapillary PH (isolated or combined) based on right heart catheterization (RHC) treated with pulmonary vasodilators from 2018 to 2023. Of 263 patients with isolated precapillary or combined PH and advanced CKD, only 17 (6%) were treated with pulmonary vasodilators; 53% (n = 9) with precapillary PH and 47% (n = 8) with combined PH. Most patients (94%, n = 16) received phosphodiesterase-5 antagonists, while 12% (n = 2) received endothelin receptor antagonists. Adverse clinical outcomes were seen in 35% of patients within a year. The use of pulmonary vasodilator did not prevent adverse outcomes in patients with precapillary PH and advanced CKD.

Keywords: chronic kidney disease; precapillary pulmonary hypertension; pulmonary hypertension; pulmonary vasodilator; right heart catheterization.

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Conflict of interest statement

Given the adherence to ethical and institutional guidelines and the main incentive of academic growth without monetary incentive for the development of this study, the authors declare no conflicts of interest present in this study.

Figures

FIGURE 1
FIGURE 1
(A, B). Line plots showing change in hemodynamic parameters at baseline and repeated RHC.
See this image and copyright information in PMC

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