2020, Number 2
<< Back Next >>
Finlay 2020; 10 (2)
Glomerular filtration result in patients with hypertensive emergencie
Tasis HM, Talavera HW, Edighill VV, Rodríguez DAM, Calvera CT, Gastón MJF
Language: Spanish
References: 21
Page: 160-169
PDF size: 338.63 Kb.
ABSTRACT
Foundation:
hypertensive emergencies may be the presentation of an underlying chronic kidney disease; in turn kidney damage may be the cause that leads to hypertensive emergency. Theoretical glomerular filtration is recommended to assess the risk of morbidity and mortality in hypertensive emergencies.
Objective:
to describe the behavior of glomerular filtration in patients with hypertensive emergencies attended at the Julio Trigo López Clinical Hospital in the period of 2016.
Methods:
a prospective cohort study of patients with hypertensive emergencies attended at the Julio Trigo López Hospital in the 2016-2018 period was performed. A total of 136 patients who met the inclusion criteria were included in the study. Glomerular filtration was calculated and patients were followed up to one year in the hypertension clinic.
Results:
mean age was 61.6 years (SD ± 13.6 years), prevalence of Fge <60 ml / min / 1.73 m2 was 30.9 %. Patients with kidney damage showed higher mean age (63.5 years; SD ± 13.9 years), higher prevalence of diabetes (61.9 %; OR 5,318; CI9 5 % 2,731 - 6,992; p <0.001), intra and extra hospital mortality 8.8% (OR: 2.44; IC 95 %: 1,933 - 2,902; p <0.001) and 14.5% (RR: 2,264; 95 % CI: 2,151 - 3,476; p <0.001) respectively compared to those without kidney damage.
Conclusions:
patients with hypertensive emergencies who have kidney damage have a worse prognosis, so a more strict follow-up and treatment are justified.
REFERENCES
Mozaffarian D, Benjamin EJ, Go AS, Arnett E, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2016 update: a report from American Heart Association. Circulation 2016;133(4):e38-e360.
Pérez MD, León JL, Dueñas A, Alfonzo JP, Navarro D, de la Noval R, et al. Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial. Comisión Nacional Técnica Asesora del Programa de Hipertensión Arterial. Ministerio de Salud Pública de Cuba. Rev Cub Med[Internet]. 2017[citado 12 Ene 2019];56(4):[aprox. 20p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232017000400001.
Instituto de Nefrología. Enfermedad renal crónica. Cuba 2012[Internet]. La Habana:Instituto Nacional de Nefrología;2012[citado 23 May 2019]. Disponible en: Disponible en: https://files.sld.cu/nefrologia/files/2013/06/anuario-nefrologia-2012.pdf.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA. 2003;289(19):2560-72.
James PA, Oparil S, Carter BL, Cushman WC, Dennison C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-20.
Taylor DA. Hypertensive crisis: a review of pathophysiology and treatment. Crit Care Nurs Clin North Am. 2015;27(4):439-47.
Muiesan ML, Salvetti M, Amosoro V, Di Somma S, Perlini S, Semplicini A, et al. An update on hypertensive emergencies and urgencies. J Cardiovasr Med. 2015;16(5):1-12.
Varounis C, Katsi V, Nihoyannopoulos P, Lekakis J, Tousoulis D. Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature. Front Cardiovasc Med. 2017;3(51):305-15.
Lagi A, Cencetti S. Hypertensive emergencies: a new clinical approach. Clin Hypertens. 2015;13(21):20.
Collins AJ, Li SL, Gilbertson DT, Liu J, Chen SC, Herzog CA. Chronic Kidney disease and cardiovascular disease in the Medicare population. Kidney. 2003;64(10):S24-S31.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(10):1296-305.
Guiga H, Decroux C, Michelet P, Loundou A, Vaisse B, Sarlon G, et al. Hospital and out-of-hospital mortality in 670 hypertensive emergencies and urgencies. J Clin Hypertens. 2017;19:(11)1137-42.
Williams B, Mancia G, Spiering W, Agabaty E, Azizi M, Burnier M, et al. Guía ESC/ESH 2018 sobre el diagnóstico y tratamiento de la hipertensión arterial. Rev Esp Cardiol[Internet]. 2019[citado 26 Abr 2020];72(2):[aprox. 20p.]. Disponible en: https://doi.org/10.1016/j.recesp.10.1016/j.recesp.2018.11.022
Figueredo R, Proenza L, Gallardo Y, Tabernilla ON. Factores de riesgos asociados con la aparición de crisis hipertensivas en pacientes de un área de salud manzanillera. Multimed[Internet]. 2018[citado 26 May 2019];22(2):[aprox. 15p.].Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=81653.
Wan SH, Slusser JP, Hodge DO, Chen HH. The vascular-renal connection in patients hospitalized with hypertensive crisis: a population-based study. Mayo Clin Proc Inn Qual Out[Internet]. 2018[citado 19 Feb 2019];2(2):[aprox. 8p.].Disponible en: https://doi.org/10.1016/j.mayocpiqo.2018.01.003.
Janke AT, McNaughton CD, Brody AM, Welch RD, Levy PD. Trends in the incidence of hypertensive emergencies in US emergency departments from 2006 to 2013. J Am Heart Assoc. 2016;5(12):221-4.
Fonseca MC, Pupo R, Hernández AN, Escobar E. Comportamiento de las urgencias y emergencias hipertensivas en un centro de diagnóstico integral, Venezuela. Rev Zoilo Marinello Vidaorrueta[Internet]. 2013[citado 12 Jul 2019];38(12):[aprox. 7p.]. Disponible en: https://10.1155/2014/413071.
Mariño M, Cabrera D. Comportamiento de la urgencia hipertensiva en pacientes con Enfermedad Renal Crónica, Holguín. Año 2010[Internet]. San Juan:Confederación Iberoamericana de Medicina Familiar;2011[citado 24 May 2019]. Disponible en: Disponible en: http://cimfwonca.org/ .
Pinna G, Pascale C, Fornengo P. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study. PLoS ONE. 2014;9(1):e93542.
Lane DA, Lip GY, Beet D. Improving survival of malignant hypertension patients over 40 years. Am J Hypertens. 2009;22(11)1199-204.
Katz JN, Gore JM, Amin A, Andersom FA, Dasta JF, Ferguson JJ, et al. Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute HyperTension (STAT) registry. Am Heart J. 2009;158(4):599-606.