Siva, N (2014) Outcome of Pulmonary Hypertension in Post Renal Transplant Recipient. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
INTRODUCTION : Pulmonary hypertension is characterized by increased pulmonary arterial pressure and secondary right ventricular failure. It is progressive, if untreated it turns fatal and rate of progression is high among renal failure patients. The prevalence of chronic kidney disease in developed world is 13%1.Both the complication worsens one another, if they co-exist. Classification of PH has gone through various changes and in 1998 PAH group have concluded with Group 1, 2, 3, 4, and 5, which was approved by WHO2. According to WHO classification pulmonary artery hypertension has 5 categories. Usually it is done by right heart catheterization and the non invasive method is Doppler echocardiography study. The echocardiography parameters taken into account are right ventricular size, thickness and function, valve anatomy and functions. AIM AND OBJECTIVES : To find the status of pulmonary hypertension present in the pre transplant period after 3rd and 6th month of renal transplantation using Doppler echocardiography. METHODS OF ESTIMATION GFR : 1. Cockcroft-Gault equation — The Cockcroft-Gault equation allows the creatinine clearance to be estimated from the serum creatinine in a patient with a stable serum creatinine. 2. MDRD study equations — several equations were derived from data on adult patients enrolled in the MDRD with six-variable equation initially and then with four variables. GFR measured at baseline using urinary clearance of iothalamate. 3. CKD-EPI is a gold standard and superior when GFR is normal or mildly reduced — The CKD-EPI equation was developed with the data pooled from 10 studies to provide a more accurate estimate of GFR among individuals with normal or only mildly reduced GFR (ie, above 60 mL/min per 1.73 m2) CONCLUSION : 14 patients with pulmonary hypertension and ESRD who has undergone renal transplant were followed up in the post transplant period. PH became normal in 11 patients during 3rd and 6th month. Of these 11 patients 5 had Hypertension and ESRD, 4 had Diabetic and ESRD, 2 had Coronary artery disease and ESRD. In the remaining 3 patients moderate PH in the pre transplant period regressed to mild PH on follow up. All the 3 co-morbid factors (DM, SHT, CAD), were present in this sub- group which may be the reason for incomplete resolution of PH. Renal transplant offers a significant resolution of PH in all sub groups in post transplant period.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Pulmonary Hypertension ; Post Renal Transplant ; Recipient. |
| Subjects: | MEDICAL > Nephrology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 11 Jul 2017 08:01 |
| Last Modified: | 11 Jul 2017 08:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1410 |
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