Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department
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 departmen...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970477/ https://www.ncbi.nlm.nih.gov/pubmed/35358283 http://dx.doi.org/10.1371/journal.pone.0266317 |
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author | Kim, Byung Sik Yu, Mi-Yeon Kim, Hyun-Jin Lee, Jun Hyeok Shin, Jeong-Hun Shin, Jinho |
author_facet | Kim, Byung Sik Yu, Mi-Yeon Kim, Hyun-Jin Lee, Jun Hyeok Shin, Jeong-Hun Shin, Jinho |
author_sort | Kim, Byung Sik |
collection | PubMed |
description | 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 m(2). RESULTS: Among the 4,821 patients, 46.7% and 5.8% had an eGFR of ≥90 and <30 mL/min/1.73 m(2), 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 m(2), 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 m(2) (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 m(2). Patients with an eGFR of 60–89 mL/min/1.73 m(2) had a higher mortality (21.1%) than those with an eGFR of ≥90 mL/min/1.73 m(2) (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. |
format | Online Article Text |
id | pubmed-8970477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-89704772022-04-01 Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department Kim, Byung Sik Yu, Mi-Yeon Kim, Hyun-Jin Lee, Jun Hyeok Shin, Jeong-Hun Shin, Jinho PLoS One Research Article 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 m(2). RESULTS: Among the 4,821 patients, 46.7% and 5.8% had an eGFR of ≥90 and <30 mL/min/1.73 m(2), 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 m(2), 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 m(2) (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 m(2). Patients with an eGFR of 60–89 mL/min/1.73 m(2) had a higher mortality (21.1%) than those with an eGFR of ≥90 mL/min/1.73 m(2) (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. Public Library of Science 2022-03-31 /pmc/articles/PMC8970477/ /pubmed/35358283 http://dx.doi.org/10.1371/journal.pone.0266317 Text en © 2022 Kim et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kim, Byung Sik Yu, Mi-Yeon Kim, Hyun-Jin Lee, Jun Hyeok Shin, Jeong-Hun Shin, Jinho Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
title | Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
title_full | Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
title_fullStr | Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
title_full_unstemmed | Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
title_short | Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
title_sort | impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970477/ https://www.ncbi.nlm.nih.gov/pubmed/35358283 http://dx.doi.org/10.1371/journal.pone.0266317 |
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