P1291PULMONARY HYPERTENSION VERSUS PULMONARY CONGESTION IN HAEMODIALYSIS PATIENTS IN RELATION TO INCREASED INTER DIALYTIC WEIGHT GAIN

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2020-06, Vol.35 (Supplement_3)
• Main Authors: ElSharkawy, Magdy, Khedr, Lina, Abdel Rahman, Ali, El Shimy, Ahmed, Shebl, Ahmed
• Format: Article
• Language: English
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfaa142.P1291

Abstract Background and Aims Volume overload is considered as an important clinical problem in HD patients. It is associated with morbid situations such as pulmonary hypertension and lung congestion. to assess the effect of increased (IDWG) on pulmonary hypertension, and lung congestion. Method This observational cross sectional study was conducted at on 60 HD patients, that were divided into Group I: 30 patients with an IDWG < 3.5% and, Group II: 30 patients with an IDWG > 3.5% of their dry weight. Pulmonary artery pressure was measured by echo and patients classified according to PAP into mild, moderate and severe pulmonary hypertension. Lung congestion in all patients was measured by lung ultrasound and patients classified into minimal, mild, moderate and severe lung congestion. Results Our study showed that pulmonary hypertension prevalence was 30% while lung congestion was 100%. Patients with increased IDWG > 3.5% (group 2) had pre HD higher PAP than those with IDWG < 3.5% (group 1) and patients with IDWG > 3.5% had more change in their PAP post HD session than those with IDWG < 3.5% but no significant difference between the change after the HD session in both groups. HD duration is an important factor in PH development over years. There is a significant relation anemia and hypercalcemia with PH. Patients with more increased IDWG > 3.5 % (group 2) had higher pulmonary congestion than those with IDWG < 3.5% (group 1) and patients with IDWG < 3.5% had more change in their lung congestion level after the HD session than those with IDWG > 3.5% but no statistical significance between the change in both groups. There was a significant relation between HD therapy duration with pulmonary congestion measured prior to the session. Conclusion on the short term increased IDWG affect lung congestion more than pulmonary hypertension.