Vol. 3, Issue 1, Part A (2021)

Background: There is an elevated risk of mortality from cardiovascular complications in patients with chronic renal failure (CRF) who regularly receive hemodialysis (HD). This investigation was designed to quantify the frequency of shunts as a potential explanation for unexplained pulmonary hypertension in ESRD patients who receive HD on a consistent basis. Methods: This prospective study was carried out on 120 persons at Benha University Hospital and Benha Teaching Hospitals. Each patient was asked to sign a document indicating their fully informed permission. A total of two groups were formed from the patients: Group 1 (n=80): Eighty-one patients with end-stage renal disease (ESRD) who are separated into two subgroups and receive regular hemodialysis (HD) via an arterio-venous shunt: Pulmonary hypertension (PHT) was present in 16 patients, while 64 patients (80%) did not have PHT. As a control group, we used Group 2 (n=40) of patients with chronic kidney disease (CKD) who were receiving conservative treatment, specifically predialysis. Results: An investigation into the relationship between systolic PAP and cardiac output (COP) revealed a positive correlation (r=0.257 and p=0.005). Months of dialysis were the only independent variable (variable contributing to PHT) that was shown to be statistically significant in multivariate regression analysis for PHT with other factors (B = 0.527, P = 0.037). Conclusions: A surprisingly high incidence of PHT among patients with ESRD receiving long-term HD with surgical arteriovenous shunt. Both ESRD and long-term HD via arteriovenous shunt may be involved in the pathogenesis of PHT by affecting pulmonary vascular resistance and COP. When the pulmonary circulation is unable to counteract the high COP caused by an arteriovenous shunt, pathological elevation of PAP occurs.