Early Blood Pressure Reduction by Intravenous Vasodilators Is Associated With Acute Kidney Injury in Patients With Hypertensive Acute Decompensated Heart

Background:Intravenous vasodilators are commonly used in patients with hypertensive acute decompensated heart failure (ADHF), but little is known about their optimal use in blood pressure (BP) management to avoid acute kidney injury (AKI). The purpose of this study was to investigate the association...

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Bibliographic Details
Published in:Circulation Journal 2019/08/23, Vol.83(9), pp.1883-1890
Main Authors: Arao, Yoshihito, Sawamura, Akinori, Nakatochi, Masahiro, Okumura, Takahiro, Kato, Hiroo, Oishi, Hideo, Yamaguchi, Shogo, Haga, Tomoaki, Kuwayama, Tasuku, Yokoi, Tsuyoshi, Hiraiwa, Hiroaki, Kondo, Toru, Morimoto, Ryota, Murohara, Toyoaki
Format: Article
Language:English
Subjects:
Acute decompensated heart failure
Acute Disease
Acute kidney injury
Acute Kidney Injury - chemically induced
Acute Kidney Injury - diagnosis
Acute Kidney Injury - epidemiology
Acute Kidney Injury - physiopathology
Aged
Aged, 80 and over
Antihypertensive Agents - administration & dosage
Antihypertensive Agents - adverse effects
Blood Pressure - drug effects
Blood pressure reduction
Female
Heart Failure - diagnosis
Heart Failure - drug therapy
Heart Failure - epidemiology
Heart Failure - physiopathology
Humans
Hypertension - diagnosis
Hypertension - drug therapy
Hypertension - epidemiology
Hypertension - physiopathology
Incidence
Injections, Intravenous
Japan - epidemiology
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Vasodilator Agents - administration & dosage
Vasodilator Agents - adverse effects
Vasodilators
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Summary:Background:Intravenous vasodilators are commonly used in patients with hypertensive acute decompensated heart failure (ADHF), but little is known about their optimal use in blood pressure (BP) management to avoid acute kidney injury (AKI). The purpose of this study was to investigate the association between systolic BP (SBP) changes and the incidence of AKI in patients with hypertensive ADHF.Methods and Results:Post-hoc analysis was performed on a prospectively enrolled cohort. We investigated 245 patients with ADHF and SBP >140 mmHg on arrival (mean age, 76 years; 40% female). We defined “SBP-fall” as the maximum percent reduction in SBP 6 h after intravenous treatment. AKI was defined as serum creatinine (SCr) ≥0.3 mg/dL, or urine output
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-19-0333