The Vascular-Renal Connection in Patients Hospitalized With Hypertensive Crisis: A Population-Based Study

Mayo Clinic Proceedings. Innovations, Quality & Outcomes
Siu-Hin WanHorng H Chen

Abstract

To determine the risks of acute kidney injury development and long-term clinical outcomes of patients with hypertensive crisis. This was a population study of Olmsted County residents with hypertensive crisis between January 1, 2000, and December 31, 2008, with follow-up until June 30, 2016. The results demonstrated that those with underlying chronic kidney disease upon admission for hypertensive crisis, defined as a systolic blood pressure above 180 mm Hg or diastolic blood pressure above 120 mm Hg, were more likely to develop acute kidney injury during hospitalization (odds ratio, 6.04; 95% CI, 1-26; P=.02). Hospitalization length of stay was increased when patients developed acute kidney injury during hypertensive crisis hospitalization (7.6±9 vs 3.4±4 days; P=.04). Furthermore, those who developed acute kidney injury had increased cardiac rehospitalization frequency over 10 years (87% vs 46%; P=.009). These results suggest that those with poor renal reserve are more likely to have further acute kidney damage in the setting of hypertensive crisis, likely due to decreased renal perfusion and neurohormonal dysregulation. In patients hospitalized for hypertensive crisis, chronic renal insufficiency was a risk factor associated ...Continue Reading

References

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Nov 17, 2015·Critical Care Nursing Clinics of North America·Deborah A Taylor

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