Prevalence and factors associated with pulmonary arterial hypertension on maintenance hemodialysis patients in Kinshasa,
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RESEARCH ARTICLE
Open Access
Prevalence and factors associated with pulmonary arterial hypertension on maintenance hemodialysis patients in Kinshasa, Democratic Republic of Congo: a cross-sectional study Yannick Mompango Engole1* , François Bompeka Lepira1, Yannick Mayamba Nlandu1, Yves Simbi Lubenga2, Augustin Luzayadio Longo1, Aliocha Nkodila1, Jean-Robert Rissassy Makulo1, Vieux Momeme Mokoli1, Justine Busanga Bukabau1, Marie-France Ingole Mboliasa1, Evariste Mukendi Kadima1, Cedric Kabemba Ilunga1, Tresor Swambulu Mvunzi2, Nazaire Mangani Nseka1 and Ernest Kiswaya Sumaili1
Abstract Background: Although cardiovascular diseases in particular Pulmonary Arterial Hypertension (PAH) is associated with, high morbid-mortality in chronic hemodialysis, but its magnitude remains paradoxically unknown in subSaharan Africa. The aim of this study was to evaluate the prevalence of PAH and associated factors in chronic hemodialysis in Sub-Saharan African population. Method: In a cross-sectional study, patients treated with HD for at least 6 months in 4 hemodialysis centers were examined. PAH was defined as estimated systolic pulmonary arterial pressure (sPAP) ≥ 35 mmHg using transthoracic Doppler echocardiography performed 24 h after the HD session. Results: Eighty-five HD patients were included; their average age was 52.6 ± 15.9 years. Fifty-seven patients (67.1%) were male. Mean duration of HD was 13.3 ± 11 months. With reference to vascular access, 12 (14.1%), 29 (34.1%) and 44 (51.8%) patients had AVF, tunneled cuff and temporary catheter, respectively. The underlying cause of ESRD was diabetes in 30 patients (35.3%). The prevalence of PAH was 29.4%. Patients with PAH had more hyponatremia (11 (44%) vs 10 (16.7%), p = 0.010). In multivariate analysis, unsecured healthcare funding (aOR 4, 95% CI [1.18– 6.018]), arrhythmia (aOR 3, 95% CI [1.29–7.34]), vascular access change (aOR 4, 95% CI [1.18–7.51]) and diastolic dysfunction (aOR 5, 95% CI [1.35–9.57] were independently associated with PAH. Conclusion: One third of hemodialysis patients exhibit PAH, which is independently associated with low socioeconomic status (unsecured funding, vascular access change) and cardiovascular complications (arrhythmia, diastolic dysfunction). Keywords: Pulmonary hypertension, Hemodialysis, Systolic pulmonary arterial pressure, Cardiovascular disease
* Correspondence: [email protected] 1 Nephrology Unit, University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence,
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