RESUMEN
INTRODUCTION: Pulmonary arterial hypertension (PAH) is an overlooked complication in CKD. PAH may be induced or aggravated by various risk factors found in CKD but the pathogenesis is not fully elucidated. ;Aim: To study the occurrence of PAH in CKD stage 4 and 5 and to study the risk factors for development of PAH in these patients. ;Method: An observational cross-sectional study was conducted on 100 patients of CKD stage 4 and 5 at VMMC and Safdarjung Hospital and all necessary investigations were done. ;Results: Out of 100 CKD patients, PAH was found in 61 patients, of which 23 had mild, 34 had moderate and 4 had severe PAH. Significant association was seen of systolic and diastolic blood pressure with high systolic blood pressure also associated with increased PAH severity. Significant association was seen of haemodialysis, arteriovenous fistula (AVF), CKD severity & haemodialysis duration. Increased hemodialysis duration & AVF were significantly associated with PAH severity also. Anaemia, low calcium, high phosphate, increased calcium phosphate product and increased intact-parathormone were significantly associated with PAH while except calcium, these were also significantly associated with increased PAH severity. Lower LVEF% was also significantly associated with PAH and its severity. None of them was an independent significant risk factor for PAH. ;Conclusion: PAH is an important complication in CKD and its severity increases with deterioration of renal function in CKD. Various risk factors are present and treatment of these can decrease the progress and severity of PAH, thereby decreasing the morbidity and mortality in CKD.