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    Acute kidney injury and cardiovascular outcomes in acute severe hypertension

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    Authors
    Szczech, Lynda A.
    Granger, Christopher B.
    Dasta, Joseph F.
    Amin, Alpesh
    Peacock, W. Frank
    McCullough, Peter A.
    Devlin, John W.
    Weir, Matthew R.
    Katz, Jason N.
    Anderson, Frederick A. Jr.
    Wyman, Allison
    Varon, Joseph
    Show allShow less
    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2010-05-12
    Keywords
    Acute Disease
    Adult
    Aged
    Antihypertensive Agents
    Cardiovascular System
    Chronic Disease
    Cohort Studies
    Comorbidity
    Female
    Glomerular Filtration Rate
    Hospitalization
    Humans
    Hypertension
    Kidney Diseases
    Male
    Middle Aged
    Morbidity
    Risk Assessment
    Severity of Illness Index
    Cardiovascular Diseases
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1161/CIRCULATIONAHA.109.896597
    Abstract
    BACKGROUND: Little is known about the association of kidney dysfunction and outcome in acute severe hypertension. This study aimed to measure the association between baseline chronic kidney disease (estimated glomerular filtration rate), acute kidney injury (AKI, decrease in estimated glomerular filtration rate > or =25% from baseline) and outcome in patients hospitalized with acute severe hypertension. METHODS AND RESULTS: The Studying the Treatment of Acute Hypertension (STAT) registry enrolled patients with acute severe hypertension, defined as > or =1 blood pressure measurement >180 mm Hg systolic and/or >110 mm Hg diastolic and treated with intravenous antihypertensive therapy. Data were compared across groups categorized by admission estimated glomerular filtration rate and AKI during admission. On admission, 79% of the cohort (n=1566) had at least mild chronic kidney disease (estimated glomerular filtration rate/min in 46%,/min in 22%). Chronic kidney disease patients were more likely to develop heart failure (P CONCLUSIONS: Chronic kidney disease is a common comorbidity among patients admitted with acute severe hypertension, and AKI is a frequent form of acute target organ dysfunction, particularly in those with baseline chronic kidney disease. Any degree of AKI is associated with a greater risk of morbidity and mortality.
    Source
    Circulation. 2010 May 25;121(20):2183-91. Epub 2010 May 10. Link to article on publisher's site
    DOI
    10.1161/CIRCULATIONAHA.109.896597
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27311
    PubMed ID
    20458014
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1161/CIRCULATIONAHA.109.896597
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