Early combination of pulmonary vasodilators prevents chronic kidney disease progression in connective tissue disease-associated pulmonary hypertension.
Adult
Aged
Antihypertensive Agents
/ adverse effects
Arterial Pressure
/ drug effects
Connective Tissue Diseases
/ complications
Disease Progression
Drug Therapy, Combination
Female
Humans
Hypertension, Pulmonary
/ diagnosis
Male
Middle Aged
Protective Factors
Pulmonary Artery
/ drug effects
Renal Insufficiency, Chronic
/ complications
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Vasodilator Agents
/ adverse effects
Ventricular Function, Right
/ drug effects
chronic kidney disease
connective tissue disease-associated pulmonary hypertension
mixed connective tissue disease
systemic lupus erythematosus
systemic sclerosis
Journal
International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
24
09
2021
received:
07
07
2021
accepted:
27
09
2021
pubmed:
10
10
2021
medline:
19
2
2022
entrez:
9
10
2021
Statut:
ppublish
Résumé
Pulmonary hypertension (PH) and chronic kidney disease (CKD) are interdependent for their development and exacerbation. We evaluated the effect of PH on CKD progression in patients with connective tissue disease (CTD)-associated PH. We reviewed consecutive patients with CTD who were diagnosed with PH with right heart catheter (RHC) examinations in our hospital. Patients were divided into 2 groups according to the use of vasodilators: monotherapy or combination therapy. We further divided the patients with combination therapy into early and non-early combination groups. Early combination was defined as the addition of the second vasodilator within 1 month after starting the first drug. The clinical course of hemodynamics and CKD progression were compared. Thirty-eight patients were included in the analysis: 10 were treated with monotherapy and 28 with combination therapy (14 with early and 14 with non-early). At baseline, patients who received combination therapy had a significantly higher mean pulmonary arterial pressure with RHC and a higher right ventricular systolic pressure (RVSP) with echocardiography (P = .04) and showed a greater improvement in RVSP after treatment than those who underwent monotherapy. The incidence of CKD progression was significantly lower in patients who received combination therapy than in those who received monotherapy (P = .05). Among patients who received combination therapy, the early combination group had a lower incidence of CKD progression than the non-early combination group (P = .03). Early combination therapy is associated with a lower incidence of CKD progression in patients with CTD-associated PH.
Identifiants
pubmed: 34626090
doi: 10.1111/1756-185X.14225
doi:
Substances chimiques
Antihypertensive Agents
0
Vasodilator Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1419-1426Informations de copyright
© 2021 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
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