Abstract: FR-PO0378
Clinical Characteristics and Outcomes of Patients with Malignant Hypertension-Associated Kidney Injury: A Single-Center Cohort Study
Session Information
- Hypertension and CVD: Clinical - 2
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Lu, Wanhong, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Li, Huixian, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Jin, Li, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
Background
Studies exploring the phenotype and prognostic factors in patients with mHTN associated kidney injury were still limited. We aimed to investigate the clinical characteristics and prognostic factors in patients with malignant hypertension associated kidney injury.
Methods
This observational cohort study incorporated both retrospective and prospective data. Patients diagnosed with mHTN (systolic blood pressure >180 mmHg or diastolic blood pressure >120 mmHg accompanied by grade III or IV hypertensive retinopathy based on the Keith-Wagener-Barker classification) and concurrent progressive renal dysfunction were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University between February 2014 and December 2024. Patients with incomplete baseline data or a follow-up period of less than three months were excluded. The primary endpoint was dialysis dependence. Univariate and multivariate logistic regression analyses were conducted to identify independent predictors of dialysis dependence.
Results
A total of 141 patients were included, with a mean age of 37.0±9.3 years; 119 (84.4%) were male. The highest recorded systolic and diastolic blood pressures were 218.0±25.8 mmHg and 141.3±20.7 mmHg, respectively. Median serum creatinine levels was 379.5 (IQR: 238.3–658.0) µmol/L. Of the 78 patients (55.3%) who underwent renal biopsy, 61 cases were diagnosed with mHTN-associated thrombotic microangiopathy (TMA), and 17 cases with IgA nephropathy with TMA. During a median follow-up of 22.5 (IQR: 9.0–47.3) months, 69 patients required maintenance dialysis. Emergency dialysis within 48 hours of diagnosis was initiated in 33 patients (23.4%), while 36 patients (29.7%) started dialysis later during follow-up. Univariate logistic regression analysis identified baseline estimated glomerular filtration rate (eGFR) (OR = 0.936, 95% CI: 0.908–0.964, P < 0.001), serum albumin (OR = 0.901, 95% CI: 0.843–0.962, P = 0.002), and haemoglobin as significant predictors of dialysis dependence. Multiple logistic regression analysis indicated that baseline eGFR as an independent predictor of dialysis dependence (OR = 0.946, 95% CI: 0.909–0.984, P = 0.005).
Conclusion
Patients with mHTN associated kidney injury have a poor prognosis. eGFR on admission was independently associated with the likelihood of requiring maintenance dialysis.