Kidney Disease and Pulmonary Hypertension

Overview

Evaluation of the prevalence of kidney disease, hemodynamic predictors and long-term renal outcome in patients with invasively diagnosed pulmonary hypertension.

Full Title of Study: “Prevalence and Predictors of Kidney Disease, and Long-Term Renal Outcome in Pulmonary Hypertension”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Retrospective
  • Study Primary Completion Date: August 27, 2018

Detailed Description

This study aims to determine the prevalence of kidney disease, hemodynamic predictors and long-term renal outcome of in-hospital patients with invasively diagnosed pulmonary hypertension at the Department of Pulmonology, University Hospital Giessen and Marburg, Giessen, Germany between 1999 and 2016.

Interventions

  • Other: No intervention
    • No intervention

Clinical Trial Outcome Measures

Primary Measures

  • Changes in estimated glomerular filtration rate (GFR) in each class of pulmonary hypertension during follow-up period
    • Time Frame: 3 years follow-up
    • Estimated GFR (Chronic Kidney Disease Epidemiology Collaboration) will be used over follow-up period to determine changes in renal function
  • Impact of renal function on deterioration of pulmonary hypertension during follow-up period
    • Time Frame: 3 years follow-up
    • Changes in estimated GFR (Chronic Kidney Disease Epidemiology Collaboration) over follow-up period will be correlated with clinical worsening of pulmonary hypertension (as determined by echocardiography, 6-minute-walk, New York Heart Association classification, b-type natriuretic peptide)

Secondary Measures

  • Impact of pulmonary hypertension-related morbidity on renal function decline
    • Time Frame: 3 years follow-up
    • Severity of pulmonary hypertension (progress pulmonary hypertension, unscheduled hospitalization due to worsening of pulmonary hypertension, mortality) will be correlated with changes in renal function (as determined by estimated GFR [Chronic Kidney Disease Epidemiology Collaboration])
  • Prevalence of proteinuria in pulmonary hypertension
    • Time Frame: At baseline
    • 24 hours urine collection at baseline will be assessed to predict progress of pulmonary hypertension
  • Impact of pulmonary hypertension-specific therapy on renal function decline
    • Time Frame: 3 years follow-up
    • Estimated GFR (Chronic Kidney Disease Epidemiology Collaboration) over follow-up period will be assessed to show association of pulmonary hypertension-specific therapy on renal function

Participating in This Clinical Trial

Inclusion Criteria

  • older than 18 years – subjects with invasively diagnosed pulmonary hypertension at rest and available renal function and spot urine data at day of right heart catheterization between March 1999 and December 2016 at the Department of Pulmonology, University Hospital Giessen and Marburg, Giessen, Germany Exclusion Criteria:

  • subjects with estimated GFR <15ml/min/1.73m2 or prior dialysis – pre-existing acute kidney injury – non-end stage renal disease with extracorporeal or peritoneal ultrafiltration due to diuretic-resistant fluid overload – primary kidney disease requiring active immunosuppression – autosomal dominant polycystic kidney disease – if subjects are pregnant – if subjects are recipients of solid-organ transplants – subjects with pulmonary hypertension with unclear/multifactorial mechanisms (WHO group 5 pulmonary hypertension)

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Giessen
  • Provider of Information About this Clinical Study
    • Principal Investigator: Faeq Husain, Senior Physician Nephrology – University of Giessen
  • Overall Official(s)
    • Werner Seeger, MD, Study Director, University Clinic Giessen and Marburg, Campus Giessen

Citations Reporting on Results

Navaneethan SD, Wehbe E, Heresi GA, Gaur V, Minai OA, Arrigain S, Nally JV Jr, Schold JD, Rahman M, Dweik RA. Presence and outcomes of kidney disease in patients with pulmonary hypertension. Clin J Am Soc Nephrol. 2014 May;9(5):855-63. doi: 10.2215/CJN.10191013. Epub 2014 Feb 27.

Husain-Syed F, Slutsky AS, Ronco C. Lung-Kidney Cross-Talk in the Critically Ill Patient. Am J Respir Crit Care Med. 2016 Aug 15;194(4):402-14. doi: 10.1164/rccm.201602-0420CP.

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