Background: Pulmonary hypertension (PH) is an unrecognized and common cardiovascular complication of End Stage Kidney Disease (ESKD). Data on its burden in sub-Saharan Africa are rare. We aimed to determine the characteristic and determinants of ESKD patients with PH on maintenance hemodialysis in a tertiary care hospital in Cameroon.
Methods: A cross-sectional study from January to July 2017 at the Douala general hospital. We included consenting ESKD under hemodialysis for more than 3 months. Relevant clinical data were recorded from patient’s files and interviews including baseline nephropathy, medications, blood pressure, inter dialytic weight gain, haemoglobin level. All patients underwent a standard echocardiography study (2D, M-mode, Doppler) within 3hours from the end of the dialysis session by the same cardiologist. PH was defined as pulmonary artery systolic pressure (PASP) > 35 mmHg and classified as: mild (PASP: 35-45 mmHg), moderate (PASP: 45-60 mmHg) and severe (PASP>60 mmHg).
Results: We included 98 patients with mean age of 49 ± 15.1 years. There was 59.2% men and 40.8% women. Left ventricular diastolic dysfunction (83.7%) and left atrium dilation (58.2%) were the frequent cardiac abnormalities. A total of 32/98 (32.7%) patients had PH with 8/98 (8.2%) mild, 13/98 (13.3%) moderate and11/98 (11.2%) severe. Diastolic blood pressure (OR=0.92, CI=0.85-0.99, p=0.011), hemoglobin level (OR=0.49, CI=0.27-0.90, p=0.006), duration on hemodialysis > 4 years (OR=42.71, CI=2.81-648.60, p=0.007) and inter dialytic weight gain (OR=2.36, CI=1.18 4.16, p=0.006) were significantly associated with PH.
Conclusion: PH seem to be frequent amongst patients on hemodialysis in our setting,with various patients related factors associated.