title: Prognostic Value of Renal Dysfunction Indicators in Normotensive Patients With Acute Pulmonary Embolism.
abstract: BACKGROUND
  Glomerular filtration rate (GFR) and blood urea nitrogen (BUN) are important prognostic indicators for cardiovascular disease. However, data on the relationship between renal dysfunction (RD) and prognosis in patients with acute pulmonary embolism (APE) are limited. The estimated-GFR (eGFR), based on the Modification of Diet in Renal Disease (MDRD) equation, has been suggested as a possible prognostic marker in patients with APE; however, at present, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is thought to be more accurate than the MDRD equation for the estimation of RD.
  
  
  OBJECTIVE
  We investigated whether eGFRCKD-EPIor BUN could predict adverse outcomes (AOs) better than eGFRMDRDin normotensive patients with APE.
  
  
  METHODS
  Ninety-nine normotensive patients with APE (aged 22-96, 56% male) were enrolled in the study retrospectively. Adverse outcomes were defined as the occurrence of any of the following: death, cardiopulmonary resuscitation, use of vasopressors, thrombolysis, or mechanical ventilation.
  
  
  RESULTS
  In univariate analyses, age, gender (male), heart rate (>110 bpm), serum creatinine, BUN, cardiac troponin (cTn) positivity, right ventricle-left ventricle ratio, eGFRMDRD, and eGFRCKD-EPIwere found to be significantly different between those with and without AOs. Comparing area under the curves for AO, we found statistically significant differences between eGFRCKD-EPIand eGFRMDRD( P = .01) but not between BUN and eGFRCKD-EPIor BUN and eGFRMDRD. Furthermore, 30-day mortality was 36% versus 11% in cTn-positive patients with an eGFRCKD-EPI< and ≥ 60 mL/min, respectively.
  
  
  CONCLUSIONS
  There is a close relationship between RD and APE prognosis. We conclude eGFRCKD-EPIis a potential prognostic marker for risk stratification in normotensive patients with APE.
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Bülent
authors.identifier: http://orcid.org/0000-0002-2481-0978
authors.initials: B
authors.lastname: Altınsoy
authors.affiliation: 2 Department of Radiology, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: İbrahim İlker
authors.initials: İİ
authors.lastname: Öz
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Tacettin
authors.initials: T
authors.lastname: Örnek
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Erboy
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Tanrıverdi
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Uygur
authors.affiliation: 3 Department of Pulmonary Medicine, School of Medicine, Namık Kemal University, Tekirdağ, Turkey.
authors.forename: Nejat
authors.initials: N
authors.lastname: Altintas
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Atalay
authors.affiliation: 1 Department of Pulmonary Medicine, School of Medicine, Bulent Ecevit University, Esenköy, Kozlu, Zonguldak, Turkey.
authors.forename: Müge Meltem
authors.initials: MM
authors.lastname: Tor
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001806:Blood Urea Nitrogen; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000503:physiopathology*; D018570:Risk Assessment; D055815:Young Adult
keywords: pulmonary embolism; renal failure; uremia