Overview
This prospective multicenter longitudinal study aims to investigate the prevalence, pathogenesis, and prognosis of pulmonary hypertension in patients with end-stage renal disease undergoing chronic hemodialysis. The research seeks to identify specific clinical factors and biomarkers like angiopoietin-2 that contribute to the development of this condition, while evaluating the prognostic value of right ventricular function measured via TAPSE. Participants undergo a standardized screening echocardiogram the day after their intermediate dialysis session to determine the probability of pulmonary hypertension. Those identified as high-risk receive further diagnostic confirmation through right heart catheterization, respiratory function tests, and lung scans to clarify the underlying etiology. The protocol also evaluates the hemodynamic impact of high-flow arteriovenous fistulas and volume overload on pulmonary pressures. Clinical follow-up is conducted at baseline and subsequently at 6, 12, and 24 months to monitor patient outcomes and standardize therapeutic management according to established European guidelines.
Eligibility
Inclusion Criteria:
- Patients aged between 18 and 75 years
- Patients on stable extracorporeal hemodialysis for at least 6 months
- Dialysis frequency of two or three times per week
- Ability to provide written informed consent
Exclusion Criteria:
- WHO functional class IV
- Presence of valvular or congenital heart disease
- Acute infections within the month preceding the cardiological evaluation
