Predictive Value of Cardiopulmonary Exercise Testing Parameters for Pulmonary Arterial Hypertension in Peritoneal Dialysis Patients-A Retrospective Study.

Abstract

Aims/Background Pulmonary arterial hypertension (PAH) is a significant contributor to increased overall and cardiovascular mortality in peritoneal dialysis (PD) patients. Cardiopulmonary exercise testing (CPET) is an accurate method for measuring cardiorespiratory fitness (CRF) during both submaximal and peak exercise. Previous studies have demonstrated a strong correlation among CRF and increased cardiovascular and overall mortality rates. However, no literature currently reports the predictive value of CPET parameters for PAH occurrence in PD patients. This study primarily aims to analyze the risk factors for PAH in PD patients, assess the predictive value of CPET parameters, and provide a reference for the clinical prevention and management of PAH. Methods The clinical data of 121 PD patients who underwent CPET were retrospectively collected at Xuzhou Medical University Affiliated Hospital. Based on the event of PAH, patients were divided into two groups: a PAH group (n = 39) and a non-PAH group (n = 82). Clinical data, laboratory results, ultrasound findings, and CPET parameters were compared between the groups. Multifactorial logistic regression analysis was performed to identify the risk factors for PAH. The predictive value of CPET parameters was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC) using ROC curve analysis. Results White blood cell count (WBC) was an independent risk factor for PAH in PD patients (p < 0.05). VO₂peak (peak oxygen uptake), VO₂AT (anaerobic threshold oxygen uptake), METspeak (peak metabolic equivalents), WRpeak (peak power load) were identified as protective factors for PAH in PD patients (p < 0.05). ROC curve analysis showed that the AUC values for predicting PAH in PD patients using VO₂peak, VO₂AT, METspeak, and WRpeak were 0.675, 0.651, 0.719, and 0.689, respectively, with METspeak demonstrating the highest AUC for prediction. Conclusion The occurrence of PAH in PD patients is associated with WBC, VO₂peak, VO₂AT, METspeak, and WRpeak. Additionally, CPET parameters exhibit predictive value for PAH, with METspeak showing the highest AUC for prediction.