Pulmonary Hypertension and Renal Function

Pathophysiological Mechanisms

• Elevated right-sided venous pressure in pulmonary hypertension is transmitted to the renal veins, increasing kidney interstitial pressure and reducing the transglomerular pressure gradient, according to the American Journal of Kidney Diseases 1
• Increased kidney interstitial pressure enhances lymphatic outflow, promoting washout of proteins and reducing colloidal osmotic pressure in the kidney interstitium, as reported by the American Journal of Kidney Diseases 1
• Management of volume status is critical to prevent worsening renal function in pulmonary hypertension, as stated by the American Journal of Kidney Diseases 1

Clinical Implications

• Chronic kidney disease is recognized as both a cause and consequence of pulmonary hypertension, with chronic renal failure listed in Group 7.4 of the clinical classification of pulmonary hypertension, according to the European Respiratory Journal 2, 3