Prognostic Value of Renal Dysfunction Indicators in Normotensive Patients with Acute Pulmonary Embolism
| Autor: | Müge Meltem Tor, Tacettin Örnek, Nejat Altintas, Bulent Altinsoy, Hakan Tanriverdi, Ibrahim Ilker Oz, Figen Atalay, Fatma Erboy, Fırat Uygur |
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| Přispěvatelé: | Zonguldak Bülent Ecevit Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Risk
Adult Male medicine.medical_specialty renal failure pulmonary embolism Equation Admission Renal function Disease 030204 cardiovascular system & hematology Kidney urologic and male genital diseases Risk Assessment Blood Urea Nitrogen 03 medical and health sciences Young Adult 0302 clinical medicine uremia Chronic Kidney-Disease Internal medicine Prevalence Medicine Humans 030212 general & internal medicine Cystatin C Mortality Blood urea nitrogen Aged Aged 80 and over business.industry Ckd-Epi Hematology General Medicine Biomarker Middle Aged medicine.disease Prognosis Uremia female genital diseases and pregnancy complications Pulmonary embolism Acute Disease Cardiology Broad-Spectrum Female business Value (mathematics) Glomerular Filtration Rate |
| Popis: | Introduction: Glomerular filtration rate (GFR) and blood urea nitrogen (BUN) are important prognostic indicators for cardiovascular disease. However, data on the relationship between renal dysfunction (RD) and prognosis in patients with acute pulmonary embolism (APE) are limited. The estimated-GFR (eGFR), based on the Modification of Diet in Renal Disease (MDRD) equation, has been suggested as a possible prognostic marker in patients with APE; however, at present, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is thought to be more accurate than the MDRD equation for the estimation of RD. Objective: We investigated whether eGFRCKD-EPI or BUN could predict adverse outcomes (AOs) better than eGFRMDRD in normotensive patients with APE. Methods: Ninety-nine normotensive patients with APE (aged 22-96, 56% male) were enrolled in the study retrospectively. Adverse outcomes were defined as the occurrence of any of the following: death, cardiopulmonary resuscitation, use of vasopressors, thrombolysis, or mechanical ventilation. Results: In univariate analyses, age, gender (male), heart rate (>110 bpm), serum creatinine, BUN, cardiac troponin (cTn) positivity, right ventricle–left ventricle ratio, eGFRMDRD, and eGFRCKD-EPI were found to be significantly different between those with and without AOs. Comparing area under the curves for AO, we found statistically significant differences between eGFRCKD-EPI and eGFRMDRD ( P = .01) but not between BUN and eGFRCKD-EPI or BUN and eGFRMDRD. Furthermore, 30-day mortality was 36% versus 11% in cTn-positive patients with an eGFRCKD-EPI < and ≥ 60 mL/min, respectively. Conclusion: There is a close relationship between RD and APE prognosis. We conclude eGFRCKD-EPI is a potential prognostic marker for risk stratification in normotensive patients with APE. |
| Databáze: | OpenAIRE |
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