Xie Y; Department of Nephrology, Xuzhou Medical University Affiliated Hospital, Xuzhou, Jiangsu, China.
Qiu X; Zhang Y; Liu Y; DeYin Z;
British journal of hospital medicine (London, England : 2005) [Br J Hosp Med (Lond)] 2024 Nov 30; Vol. 85 (11), pp. 1-13.
Date of Electronic Publication: 2024 Nov 18.
Aims/Background Pulmonary arterial hypertension (PAH) is a significant contributor to increased overall and cardiovascular mortality in peritoneal dialysis (PD) patients. Cardiopulmonary exercise testing (CPET) is an accurate method for measuring cardiorespiratory fitness (CRF) during both submaximal and peak exercise. Previous studies have demonstrated a strong correlation among CRF and increased cardiovascular and overall mortality rates. However, no literature currently reports the predictive value of CPET parameters for PAH occurrence in PD patients. This study primarily aims to analyze the risk factors for PAH in PD patients, assess the predictive value of CPET parameters, and provide a reference for the clinical prevention and management of PAH.
Methods The clinical data of 121 PD patients who underwent CPET were retrospectively collected at Xuzhou Medical University Affiliated Hospital. Based on the event of PAH, patients were divided into two groups: a PAH group (n = 39) and a non-PAH group (n = 82). Clinical data, laboratory results, ultrasound findings, and CPET parameters were compared between the groups. Multifactorial logistic regression analysis was performed to identify the risk factors for PAH. The predictive value of CPET parameters was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC) using ROC curve analysis.
Results White blood cell count (WBC) was an independent risk factor for PAH in PD patients ( p < 0.05). VO 2 peak (peak oxygen uptake), VO 2 AT (anaerobic threshold oxygen uptake), METspeak (peak metabolic equivalents), WRpeak (peak power load) were identified as protective factors for PAH in PD patients ( p < 0.05). ROC curve analysis showed that the AUC values for predicting PAH in PD patients using VO 2 peak, VO 2 AT, METspeak, and WRpeak were 0.675, 0.651, 0.719, and 0.689, respectively, with METspeak demonstrating the highest AUC for prediction.
Conclusion The occurrence of PAH in PD patients is associated with WBC, VO 2 peak, VO 2 AT, METspeak, and WRpeak. Additionally, CPET parameters exhibit predictive value for PAH, with METspeak showing the highest AUC for prediction.