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Background <p>Pulmonary hypertension (PH) is highly prevalent and associated with increased mortality in patients undergoing maintenance hemodialysis (MHD). This study aimed to explore the disparities in the prevalence, risk factors, and prognostic impacts of PH between non-elderly and elderly MHD patients.</p> Methods <p>This study included 179 MHD patients with complete clinical records. All patients were evaluated using Doppler echocardiography, and PH was defined as a pulmonary artery systolic pressure &gt; 35 mmHg.</p> Results <p>The prevalence rates of PH were 24.8% in non-elderly patients and 33.8% in elderly patients. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was a predominant risk factor for PH in hemodialysis patients. A lower ratio of uric acid to high-density lipoprotein (UHR) was associated with PH among non-elderly patients, whereas diabetes mellitus served as a specific risk factor for elderly patients. The areas under the receiver operating characteristic curves of these risk factors identified in non-elderly and elderly patients were 0.86 (bootstrap 95% confidence interval (CI) 0.78–0.93) and 0.90 (bootstrap 95% CI 0.82–0.97), respectively. During a median follow-up duration of 32.90 (4.00-61.50) months, the presence of PH notably elevated the risk of all-cause mortality and cardiovascular hospitalization in both non-elderly and elderly patients. Meanwhile, it significantly augmented the risk of all-cause hospitalization (HR: 2.24, 95% CI 1.26–3.98, <i>P</i> = 0.006) in the non-elderly.</p> Conclusions <p>Distinct risk profiles for PH were identified between non-elderly and elderly MHD patients, offering valuable clinical data for the development of early detection and prevention strategies based on age stratification.</p>

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Difference in risk profiles for pulmonary hypertension between non-elderly and elderly patients undergoing maintenance hemodialysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月5日

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  • Zhen Ai,
  • Qingling Jia,
  • Suiqin Wen,
  • Ying Zhu,
  • DiHua Zhang,
  • Raoping Wang,
  • Jianhua Wu,
  • Yuanwen Xu

摘要

Background

Pulmonary hypertension (PH) is highly prevalent and associated with increased mortality in patients undergoing maintenance hemodialysis (MHD). This study aimed to explore the disparities in the prevalence, risk factors, and prognostic impacts of PH between non-elderly and elderly MHD patients.

Methods

This study included 179 MHD patients with complete clinical records. All patients were evaluated using Doppler echocardiography, and PH was defined as a pulmonary artery systolic pressure > 35 mmHg.

Results

The prevalence rates of PH were 24.8% in non-elderly patients and 33.8% in elderly patients. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was a predominant risk factor for PH in hemodialysis patients. A lower ratio of uric acid to high-density lipoprotein (UHR) was associated with PH among non-elderly patients, whereas diabetes mellitus served as a specific risk factor for elderly patients. The areas under the receiver operating characteristic curves of these risk factors identified in non-elderly and elderly patients were 0.86 (bootstrap 95% confidence interval (CI) 0.78–0.93) and 0.90 (bootstrap 95% CI 0.82–0.97), respectively. During a median follow-up duration of 32.90 (4.00-61.50) months, the presence of PH notably elevated the risk of all-cause mortality and cardiovascular hospitalization in both non-elderly and elderly patients. Meanwhile, it significantly augmented the risk of all-cause hospitalization (HR: 2.24, 95% CI 1.26–3.98, P = 0.006) in the non-elderly.

Conclusions

Distinct risk profiles for PH were identified between non-elderly and elderly MHD patients, offering valuable clinical data for the development of early detection and prevention strategies based on age stratification.