Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and is an independent risk factor for cardiovascular disease (CVD). Pulmonary hypertension (PHT) is a common co-morbidity in patients with CKD and end-stage renal disease (ESRD) . PH is associated with increased risk of hospitalization and mortality in patients with CKD .Several studies demonstrated that PH is an independent predictor of mortality in patients with CKD, especially those receiving renal replacement therapy (RRT) .Coexisting left side heart disease, chronic lung disease, thromboembolic disease, autoimmune diseases and liver disease that are well-established risk factors for developing PH may occur in patients with CKD. However, CKD especially ESRD by itself proposed to cause pulmonary vascular remodeling and PH. Possible mechanisms that have been suggested include endothelial dysfunction due to( increased oxidative stress from uremic toxins, chronic inflammation resulting from exposure of the blood to dialysis membrane), vascular calcification, and increased flow from arteriovenous fistula (AVF)  .
Early diagnosis and early treatment of PH might improve the long-term outcomes. Therefore, it is crucial to investigate the epidemiology of PH before patients with CKD progress to ESRD .