This document outlines a study on the prevalence of pulmonary hypertension in patients with chronic kidney disease being conducted at Thanjavur Medical College. The objectives are to study the prevalence of pulmonary hypertension in CKD patients. It will be a descriptive cross-sectional study of 100 patients with stage 3 or worse CKD, excluding those with other cardiac or lung conditions. Data will be collected through questionnaires, investigations like echocardiography, and various clinical parameters will be analyzed to determine prevalence and risk factors of pulmonary hypertension in CKD patients. Ethical approval has been obtained and there are no conflicts of interest reported.

1. A COMPREHENSIVE
STUDY ON PREVALENCE OF PULMONARY
HYPERTENSION IN
CHRONIC KIDNEY DISEASE( THANJAVUR
MEDICAL
COLLEGE)
DR.DILIP KUMAR J
FIRST YEAR POSTGRADUATE
DEPARTMENT OF INTERNAL MEDICINE
THANJAVUR MEDICAL COLLEGE

2. OBJECTIVES OF THE STUDY:
• To study the prevalence of pulmonary hypertension in chronic kidney
disease( Thanjavur Medical College)

3. METHODOLOGY
• STUDY DESIGN:
• Descriptive cross-sectional study.
• STUDY SETTING:
• The study will be conducted in the inpatient wards in Nephrology
• department and Department of General Medicine, Thanjavur Medical
• College.

4. STUDY SUBJECTS:
• INCLUSION CRITERIA:
• 1) Renal function was determined by estimated glomerular filtration rate.
• 2) Only patients with stage 3 or worse CKD were included

5. • EXCLUSION CRITERIA:
• Those patients having stage 2 or less kidney disease were excluded.
• Patients with congenital heart disease, chronic thromboembolic disease, acute
• myocardial infarction and previous lung disease or cardiac transplantation
• were excluded. Data was collected by oral questionnaire, relevant
• investigations and by doing 2D- ECHO
• 3. Those not willing to participate in the study
• 4. Age <18 years

6. • 5. Valvular heart diseases
• 6.Congenital heart diseases
• 7. Pulmonary obstructive and restrictive diseases
• 8. HIV-infected patients
• 9. Chronic liver disease
• 10. Connective tissue diseases
• 11.Hypothyroidism and hyperthyroidism.

7. • SAMPLE SIZE :
• According to Atul Mann et al study, considering the prevalence of
• Pulmonary Hypertension among CKD patients (p) as 61%, with a precision
• (d) of 10%, at 95% confidence interval (Z₁₋ₐₗ₂ = 1.96), the sample size is
• calculated as
• N = Z²₁₋ₐₗ₂ * p * (1 - p) / d²
• N = 1.96² * 0.61*(1 - 0.61) / 0.1²
• N = 91
• Considering a 10% non response rate,
• N = 91 + 0.1(91)
• N = 100
• Thus the total sample size required for the study is 100

8. PARAMETER ANALYSED
• ) Age
• 2) BMI
• 3) SBP
• 4) DBP
• 5) CKD stage 4
• 6) CKD stage 5
• 7) Presence of hemodialysis Hemodialysis duration (weeks)
• 8) Presence of AVF
• 9) Presence of diabetes

9. • 10) Hemoglobin
• 11) S. Uric Acid
• 12) S. Calcium
• 13) S. Phosphate
• 14) Calcium Phosphate product
• 15) iPTH LVEF%

10. • ETHICAL ISSUES :
• According to ICMR guidelines , the risk weightage of the current
• study fits into less than minimal risk

11. • CONFLICT OF INTEREST FROM ANY OTHER INVESTIGATOR:
• There are no conflicts of interest
• We, the undersigned , have read and understood this protocol and hereby agree
• to conduct the study in accordance with this protocol and to comply with all
• requirements of the ICMR guidelines ( recent amendment)