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정창수 ( Chang Su Chun ),이영기 ( Young Ki Lee ),최종수 ( Jong Soo Choi ),이승민 ( Seung Min Lee ),송영림 ( Young Rim Song ),김수진 ( Soo Jin Min ),박태진 ( Tae Jin Park ),오지은 ( Ji Eun Oh ),서장원 ( Jang Won Seo ),윤종우 ( Jong 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.1
Purpose: Pulmonary hypertension can occur from diverse etiologies. It was reported that pulmonary hypertension also complicated dialysis patents, but the exact mechanisms were not determined. The aim of this study was to evaluate the prevalence and risk factors of pulmonary hypertension in maintenance hemodialysis patients. In addition, we studied the relationship between pulmonary hypertension and arteriovenous access. Methods: Fifty-nine chronic hemodialysis patients underwent clinical evaluation. Pulmonary artery pressure (PAP) was estimated by Doppler echocardiography. Pulmonary hypertension was defined as PAP ≥35 mmHg. Results: Mean PAP value of subjects was 39.3±13.2 mmHg. Pulmonary hypertension was found in 31 (53%) of patients receiving hemodialysis (49.0±10.6 mmHg; range 37 to 84 mmHg). Clinical and biochemical parameters did not differ significantly between patients with pulmonary hypertension and without pulmonary hypertension. In 19 patients, PAP was elevated from 27.8±10.2 mmHg to 41.8±11.9 mmHg (p<0.001) after onset of hemodialysis via arteriovenous fistula. And pulmonary hypertension developed in 12 of 15 patients with normal PAP after onset of hemodialysis treatment. Conclusion: The prevalence of pulmonary hypertension was high, and hemodialysis via arteriovenous access may be involved in the development of pulmonary hypertension.