Abstract: TH-PO635
Association of Microscopic Hematuria With Long-Term Mortality in Patients With Hypertensive Crisis
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention
Authors
- Jeong, Saeyoung, Division of Nephrology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea (the Republic of)
- Yu, Mi-yeon, Division of Nephrology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea (the Republic of)
- Shin, Jeong-Hun, Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea (the Republic of)
- Kim, Byung Sik, Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea (the Republic of)
Background
Microscopic hematuria is associated with an increased risk of chronic kidney disease and death in the general population. However, there are no data on the long-term mortality risk associated with microscopic hematuria among patients with hypertensive crisis. We hypothesized that microscopic hematuria at initial presentation in patients with hypertensive crisis would be associated with higher long-term mortality.
Methods
This retrospective study included patients admitted to the emergency department between 2016 and 2019 for hypertensive crisis (systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg). Microscopic hematuria was defined as ≥3 red blood cells per high-power field on microscopic evaluation of urine.
Results
Among the 3,595 patients, 1,359 (37.8%) had microscopic hematuria. The 3-year all-cause mortality in patients with and without microscopic hematuria were 25.5% and 16.3%, respectively. After adjusting for confounding variables, patients with microscopic hematuria (adjusted HR, 1.30; 95% CI, 1.10–1.54) showed a significantly higher risk of 3-year all-cause mortality than patients without microscopic hematuria. In a subgroup analysis according to presence of proteinuria, microscopic hematuria was a significant predictor of all-cause mortality in patients without proteinuria (adjusted HR, 1.61; 95% CI, 1.28–2.03), but not in patients with proteinuria.
Conclusion
Microscopic hematuria was a significant predictor of all-cause mortality in patients with hypertensive crisis. Our study suggests that microscopic hematuria can serve as a useful prognostic marker and permit early detection of patients with an increased risk of death. Clinicians in the emergency department should consider screening for kidney function using urine analysis during the initial assessment of patients with hypertensive crisis.