Subcutaneous treprostinil was effective and tolerable in a patient with severe pulmonary hypertension associated with chronic kidney disease on hemodialysis

Takanori Watanabe, Kotaro Abe, Koshin Horimoto, Kazuya Hosokawa, kisho ohtani, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)129-130
Number of pages2
JournalHeart and Lung: Journal of Acute and Critical Care
Volume46
Issue number2
DOIs
Publication statusPublished - Mar 1 2017

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Chronic Renal Insufficiency
Pulmonary Hypertension
Renal Dialysis
Vascular Resistance
Arterial Pressure
Lung
Subcutaneous Infusions
Syncope
Cardiac Catheterization
Dyspnea
Hemodynamics
Exercise
treprostinil
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Subcutaneous treprostinil was effective and tolerable in a patient with severe pulmonary hypertension associated with chronic kidney disease on hemodialysis",
abstract = "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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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, Kotaro

AU - Horimoto, Koshin

AU - Hosokawa, Kazuya

AU - ohtani, kisho

AU - Tsutsui, Hiroyuki

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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