TY - JOUR
T1 - Subcutaneous treprostinil was effective and tolerable in a patient with severe pulmonary hypertension associated with chronic kidney disease on hemodialysis
AU - Watanabe, Takanori
AU - Abe, Kohtaro
AU - Horimoto, Koshin
AU - Hosokawa, Kazuya
AU - Ohtani, Kisho
AU - Tsutsui, Hiroyuki
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background Pulmonary hypertension (PH) is a life-threatening complication in patients with chronic kidney disease on hemodialysis (CKD-HD). Objectives To determine whether subcutaneous infusion of treprostinil was effective and tolerable CKD-PH. Methods and results A 57-year-old man was admitted to our hospital due to presyncope and dyspnea during exercise with a history of CKD-HD. Cardiac catheterization revealed high pulmonary arterial pressure (PAP) of 53/24/32 mmHg and pulmonary vascular resistance (PVR) of 11.2 w.u. Upfront combination therapy with bosentan and sildenafil was started. However, 6-month therapy did not attenuate his symptoms, probably due to the high PAP and PVR (60/19/30 mmHg and 5.9 w.u.). We added subcutaneous treprostinil. Surprisingly, 9-month treprostinil (50 ng/kg/min) normalized hemodynamics (PAP: 25/4/13 mmHg and PVR: 1.9 w.u.). His symptoms during excise disappeared without any adverse effects. Conclusion This is the first report that subcutaneous treprostinil was very effective and tolerable in a PH patient with CKD-HD.
AB - Background Pulmonary hypertension (PH) is a life-threatening complication in patients with chronic kidney disease on hemodialysis (CKD-HD). Objectives To determine whether subcutaneous infusion of treprostinil was effective and tolerable CKD-PH. Methods and results A 57-year-old man was admitted to our hospital due to presyncope and dyspnea during exercise with a history of CKD-HD. Cardiac catheterization revealed high pulmonary arterial pressure (PAP) of 53/24/32 mmHg and pulmonary vascular resistance (PVR) of 11.2 w.u. Upfront combination therapy with bosentan and sildenafil was started. However, 6-month therapy did not attenuate his symptoms, probably due to the high PAP and PVR (60/19/30 mmHg and 5.9 w.u.). We added subcutaneous treprostinil. Surprisingly, 9-month treprostinil (50 ng/kg/min) normalized hemodynamics (PAP: 25/4/13 mmHg and PVR: 1.9 w.u.). His symptoms during excise disappeared without any adverse effects. Conclusion This is the first report that subcutaneous treprostinil was very effective and tolerable in a PH patient with CKD-HD.
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U2 - 10.1016/j.hrtlng.2017.01.004
DO - 10.1016/j.hrtlng.2017.01.004
M3 - Article
C2 - 28189266
AN - SCOPUS:85012927246
SN - 0147-9563
VL - 46
SP - 129
EP - 130
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
IS - 2
ER -