Abstract
Background
Pulmonary hypertension (PH) is associated with increased mortality in patients with
end-stage renal disease (ESRD). The prevalence of PH within ESRD as measured by right
heart catheterization (RHC) is poorly described, and the correlation of BNP to pulmonary
artery pressure (PAP) is unknown.
Methods
The renal transplant database at our center was used to identify adult ESRD patients
from July 2013 to July 2015 who had a plasma BNP level measurement and invasive hemodynamic
assessment by RHC within a 1-month period. Pulmonary hypertension was defined as a
mean pulmonary artery pressure (PAP) ≥ 25 mmHg. Multivariate linear regression analysis
was used to identify correlations between BNP and RHC parameters. To estimate the
utility of BNP in the screening of PH, a receiver-operating characteristic (ROC) curve
was generated.
Results
Eighty-eight patients were included in the study of which 43 had PH. Compared to patients
without PH, BNP was significantly higher within the PH cohort (1619 ± 2602 pg/ml vs.
352 ± 491 pg/ml). A statistically significant association (r [86] = 0.60, p<0.001) between plasma BNP and mean PAP was identified. ROC curve indicated
an acceptable predictive value of BNP in PH with a c-statistic of 0.800 (95% CI 0.708
– 0.892).
Conclusions
In ESRD patients being considered for renal transplantation, PH is highly prevalent
and BNP levels are elevated and significantly correlated with higher PAP. BNP may
be a useful non-invasive marker of PH in these patients.
Key Indexing Terms
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Article info
Publication history
Published online: September 21, 2022
Accepted:
April 15,
2022
Received:
May 30,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
