KẾT QUẢ ĐIỀU TRỊ TĂNG ÁP LỰC ĐỘNG MẠCH PHỔI MỨC ĐỘ TRUNG BÌNH - NẶNG BẰNG LỌC MÁU TÍCH CỰC Ở BỆNH NHÂN BỆNH THẬN MẠN GIAI ĐOẠN 5

Abstract

Background: Compared to conventional dialysis, intensive hemodialysis has demonstrated higher survival rates and significant improvements in quality of life. However, there is limited research on the efficacy of intensive hemodialysis in patients with pulmonary arterial hypertension (PAH) secondary to stage 5 CKD. Objective: The study aims to to evaluate the therapeutic effectiveness of intensive hemodialysis in treating moderate-to-severe PAH in patients with stage 5 CKD undergoing dialysis. Subjects and Methods: All patients diagnosed with stage 5 CKD undergoing regular dialysis diagnosed with moderate-to-severe pulmonary hypertension (PAH) at the Nephrology and Dialysis Department of Kien Giang General Hospital from August 2023 to August 2024. Results: The mean age of the study population was 44.37 ± 12.94 years, with a male-to-female ratio of approximately 1:1.2. Most patients had been on dialysis for ≥ 5 years (68.6%). The average body mass index (BMI) group constituted the highest proportion (62.9%). Hypertension and type 2 diabetes mellitus were the most common comorbidities. The mean systolic pulmonary artery pressure was 53.86 ± 11.77 mmHg before treatment, which decreased to 43.97 ± 17.04 mmHg after dialysis (p = 0.001). Dyspnea reduced from 50.0% to 23.9% (p < 0.001), edema from 73.9% to 34.8% (p < 0.001), and chest pain from 21.7% to 6.5% (p = 0.016). Among study participants, the overall treatment success rate was 65.7%, while the complication rate was 37.0%. Conclusion: The findings provide evidence supporting intensive hemodialysis as a potential therapeutic option for treating PAH in stage 5 CKD patients, particularly in those with moderate-to-severe disease severity.