Urology · 2025
Risk of Hypertension After Renal Trauma: An Analysis of a Large Insurance Claims Database.
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Kurtzman Jane T, Swallow Matthew, Horns Joshua J, Woodle Tarah, McCormick Benjamin, Myers Jeremy B
Аннотация
OBJECTIVE: To evaluate the risk of new-onset hypertension (HTN) after renal trauma (rT) using a large insurance claims database.
METHODS: We conducted a retrospective analysis of Merative MarketScan records from 2011-2017. Patients with rT were compared to controls with isolated bladder or urethral trauma. Patients were excluded if they had both trauma types, pre-existing HTN, <1 year of pre-trauma enrollment data, or age <18 years. Kaplan-Meier curves and multivariate Cox proportional hazards models assessed HTN risk between groups.
RESULTS: A total of 7882 patients (4703 rT) were included. In total, 35% of patients with rT developed de-novo HTN compared to 21% of controls (P <.001). Multivariate analysis demonstrated that patients who suffered rT were nearly twice as likely to develop de-novo HTN (hazard ration 1.8, P <.001). Patients with rT managed with either angioembolization or nephrectomy were at greatest risk of HTN (hazard ration 3.4 and 2.4, respectively, P values <.005). HTN risk was also associated with older age, female sex, higher Charlson Comorbidity Index, longer stay, diabetes, obesity, hyperlipidemia, and alcohol use.
CONCLUSION: Patients who suffer rT are at increased risk of developing de-novo HTN. Patients who undergo nephrectomy or angioembolization appear to be at the greatest risk compared to controls. Following rT, patients should be counseled on the risk of new HTN and receive close monitoring of their blood pressure over time.
METHODS: We conducted a retrospective analysis of Merative MarketScan records from 2011-2017. Patients with rT were compared to controls with isolated bladder or urethral trauma. Patients were excluded if they had both trauma types, pre-existing HTN, <1 year of pre-trauma enrollment data, or age <18 years. Kaplan-Meier curves and multivariate Cox proportional hazards models assessed HTN risk between groups.
RESULTS: A total of 7882 patients (4703 rT) were included. In total, 35% of patients with rT developed de-novo HTN compared to 21% of controls (P <.001). Multivariate analysis demonstrated that patients who suffered rT were nearly twice as likely to develop de-novo HTN (hazard ration 1.8, P <.001). Patients with rT managed with either angioembolization or nephrectomy were at greatest risk of HTN (hazard ration 3.4 and 2.4, respectively, P values <.005). HTN risk was also associated with older age, female sex, higher Charlson Comorbidity Index, longer stay, diabetes, obesity, hyperlipidemia, and alcohol use.
CONCLUSION: Patients who suffer rT are at increased risk of developing de-novo HTN. Patients who undergo nephrectomy or angioembolization appear to be at the greatest risk compared to controls. Following rT, patients should be counseled on the risk of new HTN and receive close monitoring of their blood pressure over time.