Sonographic assessment of cesarean scars: predicting risks and improving outcomes

Abstract

Background: Chronic kidney disease (CKD) presents a significant public health challenge, often complicated by comorbid conditions such as pulmonary hypertension (PH), especially in patients on hemodialysis (HD). Understanding the prevalence, risk factors, and biochemical markers associated with PH in CKD patients can inform better management strategies and improve outcomes.
Objective: To assess the prevalence of PH among CKD patients, identify key risk factors associated with its development and progression, and evaluate the impact of CKD duration, HD exposure, and biochemical markers on PH severity.
Methods: A cross-sectional study was conducted involving 250 CKD patients in a tertiary care center. Patients’ demographic and clinical data were collected, with PH diagnosed through echocardiography based on elevated right ventricular systolic pressure. Biochemical markers, including serum creatinine and calcium-phosphorus (Ca × P) product, were measured to analyze their correlation with PH presence and severity. Statistical analyses included chi-square tests for categorical variables and logistic regression for adjusted associations.

Results: The prevalence of PH in CKD patients was 77.2%, with higher rates in patients with diabetes mellitus and hypertension. PH prevalence correlated significantly with CKD duration, HD duration, and higher serum creatinine and Ca × P product levels (p < 0.05). Notably, patients on HD for over 12 months had a PH prevalence of 95.6%, indicating that prolonged HD exposure is a significant risk factor. Anemia showed a negative association with PH severity, although this was not statistically significant.
Conclusions: PH is highly prevalent in CKD patients, particularly among those with prolonged disease duration, extended HD treatment, and elevated metabolic markers. These findings highlight the need for integrated CKD management approaches that include routine PH screening, management of biochemical imbalances, and anemia control. Further research should aim to clarify the causal pathways of PH in CKD and evaluate interventions that may mitigate PH risk in this population.