Abstract

Background: Chronic kidney disease (CKD) is a global health care issue and a major burden on health care system. Pulmonary hypertension (PH) is an increase of blood pressure in pulmonary artery, vein or capillaries, it is a progressive disorder effecting heart, lung and other systems with increased morbidity and mortality regardless of etiology. The AVF is low resistance outflow tract in dialysis patient causing increased in cardiac output to maintain blood pressure which leads to development of PH.

Aim: To assess the correlation of Arteriovenous Fistula Flow with Pulmonary Hypertension in End Stage Renal Disease.

Methods: This cross-sectional descriptive study was conducted for one year. Patients were included by using Non probability purposive sampling technique.All patients had Doppler Ultrasound of fistula and graft to measure flow and at the same time was evaluated for PH by echocardiography. The data was collected for age, gender, location of AV fistula, duration of AV fistula and AV access flow.

Results: In our study the age varies between 20 to 69 years, 88 were male,141 had AV fistula as access and 84 had brachial access location. The cases above 45 had 44.3% with pulmonary hypertension as compared to <45 years with 32.3% (p-value = 0.194). The prevalence of pulmonary hypertension was insignificant for two genders, AV access type, location and duration of AV access. Among cases with AV flow more than 890 ml/min 53(89.8%) had pulmonary hypertension while only 3(3.5%) among those with AV flow <890 ml/min (p-value <0.001).

Conclusion: The AV flow above 890 ml/min was clear indication of pulmonary hypertension, and the pulmonary hypertension had no significant relation with gender, age, AV access, location and duration.

Keywords: Pulmonary hypertension, Arteriovenous Access Blood Flow, Hemodialysis.