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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Kidney dysfunction in patients with pulmonary arterial hypertension
N P Nickel1,2, J M O'Leary3, E L Brittain3
1Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Pulmonary Circulation
|July 7, 2017
Summary
Kidney dysfunction is common in pulmonary arterial hypertension (PAH) and predicts mortality. Understanding mechanisms and management is crucial for PAH patients with impaired kidney function.
Area of Science:
- Nephrology
- Cardiology
- Pulmonology
Background:
- Pulmonary arterial hypertension (PAH) and chronic kidney disease (CKD) are significant comorbidities.
- While the epidemiology of CKD in PH is studied, kidney disease in PAH (WHO group 1 PH) is less understood.
Purpose of the Study:
- To review the epidemiology of kidney dysfunction in PAH.
- To discuss potential mechanisms linking PAH and kidney disease.
- To explore management implications for kidney disease in PAH patients.
Main Methods:
- Literature review of current data on kidney dysfunction in PAH.
- Analysis of epidemiological trends.
- Discussion of proposed pathogenetic mechanisms and therapeutic strategies.
Main Results:
- Kidney dysfunction is a frequent comorbidity in PAH.
- Impaired kidney function independently predicts mortality in PAH.
- Potential mechanisms include venous congestion, reduced cardiac output, and neurohormonal activation.
- Molecular factors like TGF-β signaling and cytokines may contribute.
Conclusions:
- Kidney dysfunction is a critical issue in PAH with significant prognostic implications.
- Further research into mechanisms and targeted therapies is warranted.
- Management should address glycemic control, lifestyle, and potentially RAAS blockade.
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