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Background: Pulmonary hypertension (PH) is one of the fatal and progressive conditions in ESRD patients, its prevalence among hemodialysis patients ranging from 19% to 70% and it is responsible for 50% of mortality rate. Aim of the Work: To evaluate the effect of sildenafil on pulmonary artery pressure and six minute walk test (6MWT) in hemodialysis patients with pulmonary hypertension and detection of safety and optimum dose of the drug. Patients and Methods: Prospective, Placebo Controlled, clinical trial involving 60 ESRD patients with pulmonary hypertension from January to May 2019. Results: Group 1 (20 patients) received 25 mg sildenafil, group 2 (20 patients) received 50 mg sildenafil and group 3 (20 patients)who received placebo for 3 months .There was significant increase in mean of 6 MWT after treatment among group 1 and 2 but there is nonsignificant change among placebo group. Estimated pulmonary artery pressure (e PAP) mean after treatment showed significant decrease among group 1,2 and 3. In group 1 there was 4 patients with mild PH , 13 with moderate , 3 with severe PH after treatment 5 patients downgraded from moderate to mild and 2 patients downgraded from severe to moderate .In group 2 there was 8 patients with mild PH, 6 patients with moderate and 4 patients with severe PH after treatment 4 patients downgraded from moderate to mild PH and 2 patients downgraded from severe to moderate PH . In group 3 only one patient downgraded from moderate to mild PH. Conclusion: Our clinical trial confirmed efficiency of 50mg and 25mg sildenafil on improving e PAP and functional exercise capacity in ESRD patients with PH.

EVALUATION OF THE EFFECT OF SILDENAFIL IN HEMODIALYSIS PATIENTS WITH PULMONARY HYPERTENSION