Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department.
PLoS One
; 17(3): e0266317, 2022.
Article
in English
| MEDLINE | ID: covidwho-1974296
ABSTRACT
BACKGROUND:
The association between renal function and all-cause mortality in patients with hypertensive crisis remains unclear. We aimed to identify the impact of estimated glomerular filtration rate (eGFR) on all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED).METHODS:
This retrospective study included patients aged ≥18 years admitted to the ED between 2016 and 2019 for hypertensive crisis (systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg). They were classified into four groups according to the eGFR at admission to the ED ≥90, 60-89, 30-59, and <30 mL/min/1.73 m2.RESULTS:
Among the 4,821 patients, 46.7% and 5.8% had an eGFR of ≥90 and <30 mL/min/1.73 m2, respectively. Patients with lower eGFR were older and more likely to have comorbidities. The 3-year all-cause mortality rates were 7.7% and 41.9% in those with an eGFR ≥90 and <30 mL/min/1.73 m2, respectively. After adjusting for confounding variables, those with an eGFR of 30-59 (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.47-2.54) and <30 mL/min/1.73 m2 (HR, 2.35; 95% CI, 1.71-3.24) had significantly higher 3-year all-cause mortality risks than those with an eGFR of ≥90 mL/min/1.73 m2. Patients with an eGFR of 60-89 mL/min/1.73 m2 had a higher mortality (21.1%) than those with an eGFR of ≥90 mL/min/1.73 m2 (7.7%); however, the difference was not significant (HR, 1.21; 95% CI, 0.94-1.56).CONCLUSIONS:
Renal impairment is common in patients with hypertensive crisis who visit the ED. A strong independent association was observed between decreased eGFR and all-cause mortality in these patients. eGFR provides useful prognostic information and permits the early identification of patients with hypertensive crisis with an increased mortality risk. Intensive treatment and follow-up strategies are needed for patients with a decreased eGFR who visit the ED.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Emergency Service, Hospital
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adolescent
/
Adult
/
Humans
Language:
English
Journal:
PLoS One
Journal subject:
Science
/
Medicine
Year:
2022
Document Type:
Article
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