Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department

Kim, Byung Sik; Yu, Mi Yeon; Kim, Hyun‐Jin; Lee, Jun Hyuk; Shin, Jeong‐Hun; Shin, Jinho

doi:10.1371/journal.pone.0266317

Cited by 7 publications

(4 citation statements)

References 37 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, lymphocytes serve as regulatory and protective components of inflammatory mediators [ 42 ]. A decrease in eGFR not only signifies renal dysfunction but also indicates pathological conditions, including inflammation, microvascular disorders, and heightened oxidative stress, which are common progressive pathways observed in cardiovascular disease and chronic kidney disease, culminating in all-cause mortality [ 43 ]. Furthermore, a reduced eGFR can impact the volume and capacitance of circulation, resulting in vascular medial calcification, valvular calcification, and left ventricular hypertrophy, thereby increasing cardiovascular mortality [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension

Zhang,

Wei,

Wang

et al. 2024

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Identifying reliable prognostic markers is crucial for the effective management of hypertension. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential inflammatory marker linked to cardiovascular outcomes. This study aims to investigate the association of NLR with all-cause and cardiovascular mortality among patients with hypertension. Methods This study analyzed data from 3067 hypertensive adults in the National Health and Nutritional Examination Surveys (NHANES) from 2009 to 2014. Mortality details were obtained from the National Death Index (NDI). Restricted cubic spline (RCS) was deployed to visualize the association of the NLR with mortality risk. Weighted Cox proportional hazards models were employed to assess the independent association of NLR with mortality risk. Time-dependent receiver operating characteristic curve (ROC) analysis was conducted to access the predictive ability of NLR for survival. Mediation analysis was used to explore the indirect impact of NLR on mortality mediated through eGFR. Results Over a median 92.0-months follow-up, 538 deaths occurred, including 114 cardiovascular deaths. RCS analysis revealed a positive association between NLR and both all-cause and cardiovascular mortality. Participants were stratified into higher (> 3.5) and lower (≤ 3.5) NLR groups. Weighted Cox proportional hazards models demonstrated that individuals with higher NLR had a significantly increased risk of all-cause (HR 1.96, 95% confidence interval (CI) 1.52–2.52, p < 0.0001) and cardiovascular mortality (HR 2.33, 95% CI 1.54–3.51, p < 0.0001). Stratified and interaction analysis confirmed the stability of the core results. Notably, eGFR partially mediated the association between NLR and both all-cause and cardiovascular mortality by a 5.4% and 4.7% proportion, respectively. Additionally, the areas under the curve (AUC) of the 3-, 5- and 10- year survival was 0.68, 0.65 and 0.64 for all-cause mortality and 0.68, 0.70 and 0.69 for cardiovascular mortality, respectively. Conclusion Elevated NLR independently confers an increased risk for both all-cause and cardiovascular mortality in individuals with hypertension.

show abstract

Section: Discussionmentioning

confidence: 99%

The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension

Zhang,

Wei,

Wang

et al. 2024

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…Nonetheless, prior investigations have predominantly approached eGFR and uACR as distinct entities, seldom combining them into a composite variable for comprehensive analysis. Indeed, previous studies have shown that eGFR and uACR are independent risk factors of all‐cause mortality in hypertensive patients 10,11 . Mahmoodi et al 5 analyzed data for 45 cohorts with 364 344 participants with HTN, and found that both eGFR and uACR were associated with increased risk of cardiovascular mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, previous studies have shown that eGFR and uACR are independent risk factors of all‐cause mortality in hypertensive patients. 10 , 11 Mahmoodi et al 5 analyzed data for 45 cohorts with 364 344 participants with HTN, and found that both eGFR and uACR were associated with increased risk of cardiovascular mortality. Matsushita et al 12 analyzed 637 315 individuals without a history of CVD from 24 cohorts and found similar results.…”

Section: Discussionmentioning

confidence: 99%

Association of kidney disease index with all‐cause and cardiovascular mortality among individuals with hypertension

Fang,

Chen,

Gao

et al. 2023

Clinical Cardiology

View full text Add to dashboard Cite

BackgroundThis study aimed to investigate the association between a novel kidney disease index (KDI), which combines information from both estimated glomerular filtration rate (eGFR) and urinary albumin‐to‐creatinine ratio (uACR), and all‐cause and cardiovascular disease (CVD) mortality among individuals with hypertension.MethodsWe analyzed data from 19 988 adults with hypertension who participated in the National Health and Nutrition Examination Survey from 1999 to 2018. Mortality outcomes were determined by linking to National Death Index records through December 31, 2019. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for all‐cause and CVD mortality.ResultsBaseline KDI levels were positively associated with glucose, insulin resistance, hemoglobin A1c, triglycerides, and C‐reactive protein (p value for trend <.05). During a follow‐up period of 179 859 person‐years, a total of 5069 deaths were documented, including 1741 from cardiovascular causes. After multivariable adjustment, each standard deviation increment in KDI level was associated with a 27% increased risk of all‐cause mortality and a 31% increased risk of cardiovascular deaths (both p < .05). Further analysis showed a J‐shaped association between KDI and mortality, with the risk increasing dramatically when KDI exceeded 0.27.ConclusionElevated KDI levels were significantly associated with increased mortality from all causes and CVD among individuals with hypertension. We recommend routine testing of eGFR and uACR in hypertensive patients, and using KDI as a tool to identify individuals who are most likely to benefit from preventive therapies.

show abstract

“…Data were collected from the hospital electronic medical records. A detailed description of study design and definition in this study was reported previously [ 6 , 9 , 10 , 15 ]. Demographic and clinical characteristics, presence of acute HMOD, and diagnostic test results at the index visit of ED were collected.…”

Section: Methodsmentioning

confidence: 99%

Association of anaemia with long-term mortality among patients with hypertensive crisis in the emergency department

Kim

Shin

2022

Annals of Medicine

Self Cite

View full text Add to dashboard Cite

Background Anaemia is frequent in patients with cardiovascular disease and is significantly associated with poor prognosis. However, the prognostic significance of anaemia in hypertensive crisis remains unknown. We conducted this study to determine whether anaemia is a risk factor for all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED). Methods This retrospective study included patients who visited the ED between 2016 and 2019 for hypertensive crisis, which was defined as systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg. A total of 5,512 patients whose serum haemoglobin levels were checked were included in this study and were classified into three groups according to their serum haemoglobin levels at admission to the ED: moderate/severe anaemia (haemoglobin <11 g/dL), mild anaemia (haemoglobin 11 to <13 g/dL in men and 11 to <12 g/dL in women), and non-anaemia (haemoglobin ≥13 g/dL in men and ≥12 g/dL in women). Results Among 5,512 patients, 665 (12.1%) and 668 (12.1%) were classified into the moderate/severe anaemia and mild anaemia groups, respectively. The three-year all-cause mortality rates in the moderate/severe anaemia, mild anaemia, and non-anaemia groups were 46.0, 29.2, and 12.0%, respectively. After accounting for relevant covariates, patients with moderate/severe anaemia group (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.75–2.64) and mild anaemia group (HR, 1.32; 95% CI, 1.07–1.63) had a higher risk of 3-year all-cause mortality than the non-anaemia group. Conclusion Anaemia is independently associated with 3-year all-cause mortality in patients with hypertensive crisis. A comprehensive therapeutic approach through more in-depth examination and close follow up are required for patients with hypertensive crisis with anaemia. KEY MESSAGES Anaemia is independently associated with 3-year all-cause mortality in patients with hypertensive crisis. A comprehensive therapeutic approach through more in-depth examination and close follow up are required for patients with hypertensive crisis with anaemia.

show abstract

Impact of the estimated glomerular filtration rate on long-term mortality in patients with hypertensive crisis visiting the emergency department

Cited by 7 publications

References 37 publications

The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension

The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension

Association of kidney disease index with all‐cause and cardiovascular mortality among individuals with hypertension

Association of anaemia with long-term mortality among patients with hypertensive crisis in the emergency department

Contact Info

Product

Resources

About