P134 | Impact of venous congestion and systemic hypoperfusion on renal function in subjects with different hemodynamic phenotypes: a single-centre prospective analysis
R. Scagliola1, B. Bonino2, F.C. Viazzi2, M. Balbi3 | 1Cardiology Division, Cardinal G. Massaia Hospital, Asti, 2Nephrology and Dialysis Unit, San Martino Hospital, Genoa, 3Cardiovascular Disease Unit, San Martino Hospital, Genoa, Italy
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Premises and Purpose of the study: To investigate the relationship between cardiac index (CI) and right atrial pressure (RAP) and renal function, in patients undergoing right heart catheterization as part of their pulmonary hypertension (PH) diagnostic work-up.
Materials and Methods: From 1st September 2005 until 31st October 2019, hemodynamic data from 286 consecutive patients were collected, of whom 267 had available plasmatic creatinine values. The estimated glomerular filtration rate (eGFR) was calculated by using the Chronic Kidney Disease Epidemiology Collaboration formula.
Results: The overall study population was stratified in no PH group (n=71), pre-capillary PH group (n=107) and post-capillary PH group (n=63). Among them, eGFR was significantly lower in post-capillary PH group, compared to both no PH group and pre-capillary PH group (63.1±22.8 mL/min/1.73 m2 vs. 73.0±23.9 mL/min/1.73 m2 vs. 71.6±26.6 mL/min/1.73 m2 respectively, p=0.041). In post-capillary PH group, multivariate logistic regression analysis showed a significant correlation between eGFR<60 mL/min/1.73 m2 and both reduced CI (OR 0.05, 95% Confidence Interval 0.00 to 0.72, p=0.027) and RAP (OR 0.75, 95% Confidence Interval 0.57 to 0.99, p=0.039), compared to both no PH and pre-capillary PH groups.
Conclusions: A significant association between renal impairment and both low systemic perfusion and venous congestion, was found in patients with post-capillary PH. Further investigations are needed to disentangle the impact of the both sides of circulation on renal function in different hemodynamic phenotypes.
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