Type and severity of Kidney Impairment in patients admitted with a Hypertensive Emergency: a 5-year Retrospective Study

Background Among patients with hypertensive emergency, acute worsening of kidney function, occur in 22% - 55%. Partial kidney recovery is seen in some patients, while others rapidly progress to end-stage kidney disease. The aim of this study was to determine the severity, type and outcome of kidney impairment in patients with a hypertensive emergency (HE) in a resources-limited setting. Materials and Methods A hospital-based retrospective file analysis was carried out, and files of patients admitted with hypertensive emergency from the period 1 ^st of January 2019 to 31 ^st December 2023 were reviewed. A data extraction form was used to collect socio-demographic and clinical data from files. HE was defined according to the Joint National Committee 7 criteria, while the severity of kidney impairment (KI) was defined and graded using the Kidney Disease Improving Global Outcome (KDIGO) criteria. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 25. Results The prevalence of kidney impairment was 53.7%, with a significant increase in trend throughout the review. Acute Kidney Injury (AKI) was the most common type of KI with a prevalence of 53.2%. Eight out of ten patients with Chronic Kidney Disease (CKD) had a grade 5 CKD, and 1 out of 3 patients with AKI had a stage 3 AKI, with some requiring dialysis. Male gender (aor 4.01; 95% CI 2.13 – 7.76; p=0.01) and an increase in age (aOR 6.84; 95% CI 2.06 – 12.72; p=0.02) were significantly associated with Kidney impairment. Conclusion AKI was the most common type of kidney impairment. One out of two patients admitted with a hypertensive emergency had kidney impairment. Kidney recovery was good in AKI, and the overall mortality was high. Our findings suggest the need for scaling up of early hypertension screening before the age of forty for early detection and control.