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La lesión renal aguda y los resultados cardiovasculares en la hipertensión aguda severa aguda
Lynda A Szczech1, Christopher B Granger, Joseph F Dasta
1Department of Medicine, Division of Nephrology, Duke University Medical Center, Box 3646, Durham, NC 27710, USA. szcze001@mc.duke.edu
Circulation
|May 12, 2010
Resumen
Los pacientes con hipertensión severa aguda y enfermedad renal crónica tienen un mayor riesgo de lesión renal aguda (IRA) y peores resultados. AKI aumenta significativamente la morbilidad y la mortalidad en estos pacientes.
Área de la Ciencia:
- Nefrología Nefrología.
- Cardiología Cardiología.
- Medicina de cuidados críticos Medicina de cuidados críticos.
Sus antecedentes:
- El impacto de la disfunción renal en los resultados en la hipertensión aguda grave no se entiende bien.
- La enfermedad renal crónica (ERC) es una afección común que afecta la función renal.
- La lesión renal aguda (IRA) representa una disminución significativa en la función renal.
Objetivo del estudio:
- Evaluar la asociación entre la ERC basal (eGFR) y el AKI con los resultados de los pacientes.
- Para analizar los resultados en pacientes hospitalizados con hipertensión severa aguda aguda.
Principales métodos:
- Se utilizaron datos del registro STAT (Estudiando el tratamiento de la hipertensión aguda).
- Se incluyeron pacientes con hipertensión aguda severa tratados con antihipertensivos intravenosos.
- Pacientes categorizados por eGFR basal y presencia de AKI durante la hospitalización.
Principales resultados:
- Se observó una alta prevalencia de ERC (79%) en pacientes con hipertensión severa aguda.
- Los pacientes con ERC tenían un mayor riesgo de insuficiencia cardíaca, infarto de miocardio y IAC.
- AKI se relacionó con mayores riesgos de insuficiencia cardíaca, paro cardíaco y mortalidad a los 90 días.
- Cualquier disminución en el eGFR durante la hospitalización predijo de forma independiente un mayor riesgo de mortalidad.
Conclusiones:
- La ERC es una comorbilidad frecuente en las admisiones de hipertensión severa aguda.
- AKI es una complicación común, especialmente en pacientes con ERC preexistente.
- AKI se asocia con un aumento de la morbilidad y la mortalidad en esta población de pacientes.
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