{
  "abstract": "Background Malignant hypertension (mHTN) is an acute form of hypertension with multiorgan damage, including renal impairment. Renal cortical thickness (RCT) by ultrasonography is associated with renal function in kidney disease. However, the relationship between RCT and renal dysfunction in mHTN is not yet fully understood.Design A cohort study.Setting This was a study conducted between January 2008 and June 2023 at the First Affiliated Hospital of Sun Yat-sen University.Participants A total of 292 mHTN patients with thrombotic microangiopathy (TMA) who underwent renal biopsy were included in the study.Primary outcomes and measures Patient characteristics for RCT were examined using linear regression. The association between RCT and an increase in estimated glomerular filtration rate (eGFR) of ≥15% was analysed by Cox regression. RCT was analysed in two groups classified by median RCT.Results Overall, patients with larger RCT exhibited a lower global sclerosis ratio and a lower proportion of intravascular thrombosis. RCT was strongly positively correlated with mean kidney length (coefficient B 1.018; 95% CI 0.638 to 1.397; p<0.001), body mass index (BMI) (coefficient B 0.146; 95% CI 0.075 to 0.217; p<0.001) and negatively related to intravascular thrombosis (coefficient B −1.314; 95% CI −2.060 to −0.567; p=0.001) and tubular atrophy/interstitial fibrosis ratio (coefficient B −0.880; 95% CI −1.569 to −0.192; p=0.012). Moreover, larger RCTs had a better renal function improvement of ≥15% increase in eGFR in patients with mHTN with TMA (HR 1.745; 95% CI 1.012 to 3.009; p=0.045).Conclusions Smaller RCTs were correlated with a decline in renal function and deterioration of renal pathology. Furthermore, larger RCTs showed a better renal function improvement of ≥15% increase in eGFR in mHTN patients with TMA. RCT may be a predictive factor for renal damage in mHTN.",
  "authors": [
    {
      "affiliations": [
        "Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China"
      ],
      "name": "Shibo Wei"
    },
    {
      "affiliations": [
        "Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China"
      ],
      "name": "Sheng Zhao"
    },
    {
      "affiliations": [
        "Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China"
      ],
      "name": "Zhaocai Zhou"
    },
    {
      "affiliations": [
        "Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China"
      ],
      "name": "Rong Lian"
    },
    {
      "affiliations": [
        "Department of Geriatrics, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China"
      ],
      "name": "Xingji Lian"
    },
    {
      "affiliations": [
        "Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China"
      ],
      "name": "Zhong Zhong"
    },
    {
      "affiliations": [
        "Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China"
      ],
      "name": "Shicong Yang"
    },
    {
      "affiliations": [
        "Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China"
      ],
      "name": "Naya Huang"
    },
    {
      "affiliations": [
        "Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China"
      ],
      "name": "Yunuo Wang"
    },
    {
      "affiliations": [
        "Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China"
      ],
      "name": "Wei Chen"
    },
    {
      "affiliations": [
        "Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China"
      ],
      "name": "Jianbo Li"
    },
    {
      "affiliations": [
        "Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China"
      ],
      "name": "Feng He"
    }
  ],
  "title": "Association of renal cortical thickness and renal function in patients with malignant hypertension with thrombotic microangiopathy: a biopsy-based cohort study from China",
  "uid": "5b0d9b5f-63e1-5b35-98bc-0949a26bce11"
}