Impact of Admission Hypertension on Rates of Acute Kidney Injury in Intracerebral Hemorrhage Treated with Intensive Blood Pressure Control
| Autor: | Joseph E. Vandigo, Jacob Marler, G. Morgan Jones, Jason J. Chang, Hannah Hewgley, Stephen C. Turner, Heather Snyder |
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| Rok vydání: | 2018 |
| Předmět: |
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medicine.medical_specialty Comorbidity Critical Care and Intensive Care Medicine Logistic regression Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Internal medicine Post-hoc analysis Humans Medicine cardiovascular diseases 030212 general & internal medicine Aged Cerebral Hemorrhage Retrospective Studies Intracerebral hemorrhage Univariate analysis business.industry Acute kidney injury Odds ratio Acute Kidney Injury Middle Aged medicine.disease Blood pressure Hypertension Female Neurology (clinical) business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Neurocritical Care. 28:344-352 |
| ISSN: | 1556-0961 1541-6933 |
| DOI: | 10.1007/s12028-017-0488-2 |
| Popis: | Current guidelines recommend that rapid systolic blood pressure (SBP) lowering to 140 mmHg may be considered in intracerebral hemorrhage (ICH) patients regardless of initial SBP. However, limited safety data exist in patients presenting with varying degrees of severe hypertension. The purpose of this study was to determine whether there was an increased risk of acute kidney injury (AKI) based upon degree of presentation hypertension in ICH patients whose blood pressure was reduced intensively. This retrospective, cohort study evaluated ICH patients treated with intensive blood pressure control (SBP ≤140 mmHg) who presented with three degrees of presentation hypertension: mild (SBP 141–179 mmHg), moderate (SBP 180–219 mmHg), and severe (SBP ≥ 220 mmHg). Univariate analysis of demographics variables, ICH severity, and factors known to impact AKI was conducted between the three groups. Post hoc testing was used to compare differences between specific groups, with a Bonferroni correction adjusting for multiple comparisons. Additionally, we conducted logistic regression analysis to determine whether baseline SBP group independently predicted AKI. We included 401 patients (177 with mild, 124 with moderate, and 100 with severe hypertension). There was a significant increase in the prevalence of AKI between groups, with the severe group experiencing the highest rate (p |
| Databáze: | OpenAIRE |
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