METHODS
The current study was planned as a cross-sectional observational study
that included eighty ESRD patients >18 years on a regular
dialysis program for at least six months, and
forty healthy subjects. Patients
were recruited from the dialysis unit of the XXXX Hospital, between
January 2020 and June 2020. Those undergoing dialysis were grouped as
follows: forty patients on PD and forty patients on HD with AVF.
Patients undergoing HD were receiving standard bicarbonate HD sessions
three times per week, lasting four hours. Every participant provided
informed consent. The study was conducted in accordance with the
Declaration of Helsinki and approved by the local Ethics Committee
(2019-398).
Clinical or echocardiographic evidence of ischemic heart disease, left
ventricular systolic dysfunction with an ejection fraction (EF) of less
than 55%, valvulopathy, left bundle branch block, atrial fibrillation,
previous renal transplantation were accepted as exclusion criteria. Any
clinical condition that might predispose the patient to pulmonary
hypertension (chronic obstructive pulmonary disease, interstitial lung
diseases, connective tissue disorders, chronic thromboembolic disease,
congenital left-to-right shunt, primary pulmonary hypertension), was
also a criterion for exclusion.
All of the patients were subjected to a comprehensive clinical
evaluation. Blood pressure (BP) was measured after at least 10-minutes
rest in a sitting position. The mean of three measurements of each
patient was recorded. Patients were defined as having hypertension (HT)
if their SBP was >140 mmHg, their DBP was >90
mmHg, or they were using an antihypertensive medication.8 Diabetes was defined by treatment with anti-diabetic
medications. Body mass index (BMI) was calculated as body weight divided
by height squared (kg/m2). Body surface area (BSA; in
m2) was calculated as 0.0061 x height (cm) + 0.0124 x
weight (kg) – 0.0099.