Overview
The objective of this study is to examine the association between urinary and plasma biomarkers and the change of estimated glomerular filtration rate (eGFR) in patients with pulmonary hypertension (PH) as a tool to identify patients at high risk for short-term eGFR decline.
Description
PH is a severe, progressive disease associated with right ventricular dysfunction, right-sided heart failure (HF) and death. Chronic kidney disease (CKD) is approximately 35% in patients with PH, and its presence is associated with an enhanced risk for adverse outcomes, with the risk increasing incrementally with declining kidney function. Poor right ventricular function may increase venous congestion, alter ventricular interdependence, decrease effective cardiac output and activate the renin-angiotensin- aldosterone system, thereby aggravating kidney disease. To date, biomarkers for assessment of CKD progression in PH are lacking. The objective of this study is to examine the association between urinary and plasma biomarkers and the change of eGFR in patients with PH, aiming to identify those at high risk for short-term eGFR decline.
Eligibility
Inclusion Criteria:
- Inpatients aged ≥18 years
- undergoing right heart catheterization (RHC)
Exclusion Criteria:
- active tumor disease
- inflammatory or autoimmune disease requiring systemic immunosuppressive treatment
- CKD with eGFR <20 ml/min/1.73 m2
- non-kidney failure requiring extracorporeal or peritoneal ultrafiltration for diuretic-resistant volume overload
- if they had received non-steroidal anti-inflammatory drugs or intravenous contrast within 72 hours before RHC
- glomerulonephritis
- polycystic kidney disease
- postrenal obstruction
- solid organ transplantation
- anticipated life expectancy of <12 months
- likelihood of receiving advanced therapy (mechanical circulatory assist device/lung or cardiac transplant)
- pregnancy or possibility of pregnancy in the next 12 months
