介绍：透析患者往往会合并肺动脉高压（PH），其可以导致患者生存率下降。但是以前尚没有肾移植受者的生存率和PH之间关系的研究。方法：在此次回顾性研究中，我们采用超声心动图和测量右心室收缩压（RVSP）监测了215名肺动脉高压的的肾移植候选受者。结果：68%的患者RVSP正常（<35 mmHg），47名患者（22%）RVSP轻中度升高（36-50），22名患者（10%）RVSP明显升高（超过50），严重的肺动脉高压。维持透析的时间是与RVSP的升高关联最强（r=0.253, P<0.001），该联系独立于其它变量。未进行透析、透析少于1年、透析1-2年、透析超过2年的患者分别有25%、25%、38%、58%观察到肺动脉高压。超过50mmHg的RVSP与移植后生存率显著下降相关（hazard ratio =3.75 [1.17-11.97], P=0.016）。该相关性独立于其他变量因素，包括更大的年龄、左心室射血分数下降、低蛋白血症和移植物功能延迟恢复。结论：这些研究首次提出肾移植后PH与患者生存率相关。

Issa N, Krowka MJ, Griffin MD, Hickson LJ, Stegall MD, Cosio FG.
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

INTRODUCTION: Pulmonary hypertension (PH) is common in patients on dialysis where it is associated with reduced survival. The possible association between PH and kidney transplant recipient survival has not been previously evaluated. METHODS: In this retrospective study, we screened for PH pretransplant in 215 transplant candidates using cardiac echocardiography and measurements of right ventricular systolic pressure (RVSP). RESULTS: Sixty-eight percent of patients had normal RVSP (<35 mm Hg), 47 (22%) had mild to moderately elevated RVSP (36-50), and 22 (10%) had markedly elevated RVSP more than 50 suggestive of severe PH. Time on dialysis was the strongest correlate of an elevated RVSP (r=0.253, P<0.001) and this relationship was independent of other variables. Elevated RVSP was observed in 25%, 25%, 38%, and 58% of patients not on dialysis, on dialysis for less than 1 year, more than 1 to 2 years, or more than 2 years, respectively. An RVSP more than 50 was associated with significantly reduced posttransplant survival (hazard ratio =3.75 [1.17-11.97], P=0.016). This relationship seemed to be independent of other variables including older age, reduced left ventricular ejection fraction, low serum albumin, and delayed graft function. CONCLUSION: These analyses suggest for the first time that pretransplant PH correlates with patient survival after kidney transplantation.