Evaluation of pulmonary artery pressure variations in end stage renal disease patients before and after renal transplantation

Aims: This study aims to evaluate changes in systolic pulmonary artery pressure (sPAP) in end-stage renal disease (ESRD) patients before and after kidney transplantation, as well as the prevalence and impact of pulmonary hypertension (pHT) on post-transplant outcomes. Methods: A total of 87 ESRD patients undergoing kidney transplantation at the Nephrology Department of Ankara University Faculty of Medicine were prospectively followed. Demographic data, pretransplant, and posttransplant (3rd and 12th months) serum tests, as well as echocardiographic measurements, were analyzed. Patients with pHT due to non-renal causes were excluded. Mean systolic pulmonary artery pressure was measured echocardiographically and a level of above 30 mmHg was accepted as pHT. Statistical analyses were performed using SPSS, with a p-value <0.05 considered statistically significant. Results: Among the 87 patients, 40 (45.9%) were male and 47 (54.1%) were female, with a mean age of 42.6±11.7 years. The mean pretransplant sPAP was 36.6±7.97 mmHg, which decreased significantly to 31.7±5.5 mmHg at 3 months and 30.1±6.2 mmHg at 12 months post-transplant (p<0.05). Pretransplant pHT was present in 72.4% of patients, which reduced to 36.7% at 3 months and 22.9% at 12 months post-transplant. Preoperative triglyceride and parathormone levels were significantly correlated with sPAP (p<0.05), while patients with pretransplant sPAP ?40 mmHg had a higher incidence of early graft dysfunction (p<0.05). Conclusion: Pulmonary hypertension is prevalent in patients with ESRD but significantly decreases after kidney transplantation. Patients with preoperative sPAP ?40 mmHg are at higher risk for early graft dysfunction, highlighting the importance of screening for pHT in transplant candidates. Addressing pHT in ESRD patients may improve post-transplant outcomes, reduce morbidity, and enhance overall patient management.