Abstract: TH-PO1083
Impact of CKD on Complications of Hypertensive Emergency
Session Information
- CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Kavcar, Akil Serdar, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
- El Sharu, Husam, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
- Khdeir, Omar, East Carolina University Brody School of Medicine, Greenville, North Carolina, United States
- Surapaneni, Anish, Prima Healthcare, Westland, Michigan, United States
Background
Hypertension in chronic kidney disease (CKD) is primarily volume-dependent. We sought to examine the impact of CKD on the development of complications in hospitalizations with hypertensive emergency.
Methods
We conducted a retrospective cohort study using the National Inpatient Sample from 2016-2019. We used the International Classification of disease-10 to identify hospitalizations with hypertensive emergency and then stratified them based on whether they had CKD. We used Chi-square and t-test to compare categorical and continuous outcomes, respectively. Multivariate regression analysis was used to adjust for confounders. Adjusted odds ratios (aOR) were reported with 95% confidence intervals (CI) and results were considered statistically significant if P values <0.05.
Results
Among the 750,595 total hospitalizations with hypertensive emergency 335,805 had CKD. The mean age was 63 (without CKD) VS 61 (with CKD). Of those with CKD, 45% were African Americans and 35% were Caucasians. After adjusting for patient demographics, comorbidities, and hospital characteristics those with CKD had higher odds of developing acute kidney injury (aOR: 2.85, p<0.001, CI: 2.77 - 2.94), acute pulmonary edema (aOR: 1.94, p<0.001, CI: 1.79 - 2.09), and retinal hemorrhage (aOR: 1.96, p<0.001, CI: 1.36 - 2.81). CKD was associated with lower odds of developing aortic dissection (aOR: 0.44, p<0.001, CI: 0.4 - 0.5), subarachnoid hemorrhage (aOR: 0.34, p<0.001, CI: 0.32 - 0.35), and acute ischemic stroke (aOR: 0.42, p<0.001, CI: 0.4 – 0.44). There was no statically significant difference in the odds of developing acute coronary syndrome (aOR: 1.03, p=0.395, CI: 0.96 - 1.1) and posterior reversible encephalopathy syndrome (aOR: 1.06, p=0.226, CI: 0.96 - 1.18).
Conclusion
Among hospitalizations with hypertensive emergency, CKD was associated with higher odds of acute kidney injury, acute pulmonary edema, and retinal hemorrhage.