Letter to the Editor
Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients
Hipertensão pulmonar inexplicável em pacientes em diálise peritoneal e hemodiálise
H. Nasri
Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran
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Soares Pires, M. van Zeller, R. Reis, A. Carvalho, R. Duarte" "autores" => array:5 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Soares Pires" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "van Zeller" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Reis" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Carvalho" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Duarte" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0873215913000792" "doi" => "10.1016/j.rppneu.2013.06.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215913000792?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173511513000675?idApp=UINPBA00004E" "url" => "/21735115/0000001900000005/v3_201405231121/S2173511513000675/v3_201405231121/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "238" "paginaFinal" => "239" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "H. Nasri" "autores" => array:1 [ 0 => array:3 [ "nombre" => "H." "apellidos" => "Nasri" "email" => array:2 [ 0 => "hamidnasri@med.mui.ac.ir" 1 => "hamidnasri@yahoo.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Hipertensão pulmonar inexplicável em pacientes em diálise peritoneal e hemodiálise" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the nice article by Etemadi and colleagues, in your journal, <span class="elsevierStyleItalic">Revista Portuguesa de Pneumologia</span>, entitled “Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients”.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In a retrospective study of chronic hemodialysis and peritoneal dialysis patients, pulmonary hypertension was found in 14 (41.1%) patients of the hemodialysis group and in 6 (18.7%) patients of the peritoneal dialysis group, where pulmonary hypertension was defined as a systolic pulmonary artery pressure (SPAP)<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>mmHg. They concluded that unexplained pulmonary hypertension seems to be more frequent in patients undergoing hemodialysis than with patients in the peritoneal dialysis group. In this context, I would like to make a few points about pulmonary hypertension in dialysis patients. In a study of 102 maintenance hemodialysis patients, we found pulmonary artery pressure of 41.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.6<span class="elsevierStyleHsp" style=""></span>mmHg. In our study, 76.5% of hemodialysis patients had SPAP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>mmHg. In this study we can also see that pulmonary artery pressure had significant positive correlation with the duration and degree of hemodialysis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In another study we also observed that pulmonary artery pressure had significant positive correlation with serum intact parathormone.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Pulmonary arterial hypertension is a serious cardiac complication among patients with end-stage kidney disease, especially patients on hemodialysis as mentioned in the study by Etemadi et al., and we need to look for other aggravating factors among dialysis patients.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a> In order to achieve better understanding about this aspect of dialysis patients, more clinical studies are suggested.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-03-28" "fechaAceptado" => "2013-05-21" "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Etemadi" 1 => "H. Zolfaghari" 2 => "R. Firoozi" 3 => "M.R. Ardalan" 4 => "M. Toufan" 5 => "M.M. Shoja" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rppneu.2011.07.002" "Revista" => array:6 [ "tituloSerie" => "Rev Port Pneumol" "fecha" => "2012" "volumen" => "18" "paginaInicial" => "10" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21920698" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary artery pressure in maintenance hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Nasri" 1 => "Sh. Shirani" 2 => "A. 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