ArticleKidney medicine2026
The Association Between Pulmonary Hypertension, End-Stage Kidney Disease, and Death: An Analysis of the Chronic Renal Insufficiency Cohort Study (CRIC).
Article in Kidney medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Rationale & Objective: Pulmonary hypertension (PH) is highly prevalent in patients with chronic kidney disease and has been shown to be associated with an increased risk of death and cardiovascular disease in prior studies; however, its association with kidney outcomes is less clear. We evaluated the association between PH and tricuspid regurgitation velocity (TRV) with incident kidney failure with replacement therapy (KFRT) and secondarily death. Study Design: Longitudinal prospective cohort study. Setting & Participants: 2,419 participants from the Chronic Renal Insufficiency Cohort Study (CRIC). Exposures: PH, defined as a TRV >2.8 m/s on echocardiograms, and also using TRV as a continuous variable. Outcomes: KFRT, death before and after KFRT. Analytical Approach: Time-updated Cox proportional hazards model using multiple TRV measurements per participant adjusted for demographics, comorbid conditions, medications, laboratory values, and echocardiographic features. Results: At baseline, 343 participants (14.2%) had PH and 134 (5.5%) developed PH after 7 years of serial echocardiograms. Over a median follow-up duration of 12.1 years, 751 (31.0%) reached KFRT and over 13.1 years 978 (40.4%) died. PH was associated with a 60% higher risk of KFRT when compared with participants who did not have PH (HR, 1.60; 95% CI, 1.33-1.92) and a 68% higher risk of death (HR, 1.68; 95% CI, 1.45-1.95). Each 1 SD higher TRV was associated with 20% higher risk of KFRT (HR, 1.20; 95% CI, 1.12-1.28) and a 23% higher risk of death (HR, 1.23; 95% CI, 1.16-1.30). Limitations: Use of TRV as a proxy to define PH rather than right heart catheterization. Conclusions: PH is associated with an increased risk of KFRT and death in participants with chronic kidney disease.
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