Association Between Invasive Cardiac Hemodynamics and Kidney Function in Patients with Pulmonary Hypertension

Area of Science:

• Cardiology
• Nephrology
• Pulmonary Medicine

Background:

• Chronic kidney disease (CKD) is prevalent in pulmonary hypertension (PH) patients, increasing mortality risk.
• A hypothesis suggests that impaired invasive hemodynamics correlate with CKD development in PH patients.

Purpose of the Study:

• To investigate the association between invasive hemodynamic parameters and the prevalence and incidence of CKD in patients with PH.
• To identify specific hemodynamic markers predictive of CKD development in this population.

Main Methods:

• Analysis of 9,195 patients with incident PH from a prospective registry, including baseline CKD and creatinine values.
• Logistic regression and Cox proportional hazards models assessed associations between hemodynamics, baseline CKD, and incident CKD, adjusting for clinical factors and baseline eGFR.

Main Results:

• At baseline, 45.3% of participants had CKD stage 3. Higher right atrial pressure, pulmonary arterial wedge pressure, mean pulmonary artery pressure, pulmonary vascular resistance, and lower cardiac index were linked to higher CKD prevalence.
• Over a median follow-up of 2.5 years, 45.1% of participants developed incident CKD stage 3a. Higher right atrial pressure, pulmonary vascular resistance, and lower cardiac index were associated with increased CKD development risk.

Conclusions:

• The incidence of CKD is notably high among patients diagnosed with pulmonary hypertension.
• Adverse hemodynamic markers in PH are significantly associated with reduced estimated glomerular filtration rate (eGFR) and an elevated risk for developing CKD.