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The following is a summary of “Treatment Effect Heterogeneity in Acute Kidney Injury Incidence Following Intravenous Antihypertensive Administration for Severe Blood Pressure Elevation During Hospitalization,” published in the November 2024 issue of Nephrology by Ghazi et al.
Severe hypertension (sHTN) develops in 10% of patients hospitalized for non-hypertension reasons and increases the risk of acute kidney injury (AKI). This study examines the variability in intravenous (IV) antihypertensive effects on AKI incidence in patients with sHTN.
Researchers conducted a prospective study to examine the impact of IV antihypertensive treatment on AKI incidence in patients with sHTN.
They applied an accelerated failure time Bayesian Additive Regression Trees (BART) model to examine the time to AKI and predictors. Treatment effects were estimated for each participant to identify characteristics linked to response variability to IV antihypertensives.
The results showed that of 11,951 patients with sHTN, 741 received IV antihypertensives, and 11,210 did not. AKI developed in 18% of treated and 13% of untreated patients. Most patients were harmed by IV treatment, except for 317 White patients with an SBP ≥156 mmHg, estimated glomerular filtration rate (eGFR) ≥70.7 ml/min/1.73m2, and serum bicarbonate <21.7 mmol/L.
Investigators concluded that most patients with sHTN did not benefit from IV antihypertensive treatment. Future studies were recommended to assess treatment heterogeneity in managing sHTN.
Source: ajkd.org/article/S0272-6386(24)01081-3/fulltext#author-abstract
