{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:45:56Z","timestamp":1791639956134,"version":"4.3.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI13\/02502"],"award-info":[{"award-number":["PI13\/02502"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PICI14\/00350"],"award-info":[{"award-number":["PICI14\/00350"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI16\/01685"],"award-info":[{"award-number":["PI16\/01685"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI19\/01624"],"award-info":[{"award-number":["PI19\/01624"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014440","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003329","name":"Ministerio de Econom\u00eda y Competitividad","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Thrombotic microangiopathy (TMA) is a complication of malignant hypertension (mHTN) attributed to high blood pressure (BP). However, no studies have investigated in patients with mHTN of different aetiologies whether the presence of TMA is associated with specific causes of mHTN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We investigated the presence of TMA (microangiopathic haemolytic anaemia and thrombocytopenia) in a large and well-characterized cohort of 199 patients with mHTN of different aetiologies [primary HTN 44%, glomerular diseases 16.6%, primary atypical haemolytic uraemic syndrome (aHUS) 13.1%, renovascular HTN 9.5%, drug-related HTN 7%, systemic diseases 5.5%, endocrine diseases 4.5%]. Outcomes of the study were kidney recovery and kidney failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patients with TMA [40 cases (20.1%)] were younger, were more likely female and had lower BP levels and worse kidney function at presentation. Their underlying diseases were primary aHUS (60%), drug-related mHTN (15%), glomerular diseases [all of them immunoglobulin A nephropathy (IgAN); 10%], systemic diseases (10%) and primary HTN (5%). The presence of TMA was 92.3% in primary aHUS, 42.9% in drug-related HTN, 36.4% in systemic diseases, 12.1% in glomerular diseases and 2.3% in primary HTN. No patient with renovascular HTN or mHTN caused by endocrine diseases developed TMA, despite BP levels as high as patients with TMA. A higher proportion of TMA patients developed kidney failure as compared with patients without TMA (56.4% versus 38.9%, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The presence of TMA in patients with mHTN should guide the diagnosis towards primary aHUS, drug-related mHTN, some systemic diseases and IgAN, while it is exceptional in other causes of mHTN.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfac248","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T13:56:30Z","timestamp":1661349390000},"page":"1217-1226","source":"Crossref","is-referenced-by-count":48,"title":["Thrombotic microangiopathy in patients with malignant hypertension"],"prefix":"10.1093","volume":"38","author":[{"given":"Teresa","family":"Cavero","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital Universitario 12 de Octubre , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Au\u00f1\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario 12 de Octubre , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5830-9663","authenticated-orcid":false,"given":"Fernando","family":"Caravaca-Font\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario 12 de Octubre , Madrid , Spain"},{"name":"Research Institute Hospital Universitario 12 de Octubre , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3520-1422","authenticated-orcid":false,"given":"Hernando","family":"Trujillo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario 12 de Octubre , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Arjona","sequence":"additional","affiliation":[{"name":"Centro de Investigaciones Biol\u00f3gicas , Consejo Superior de Investigaciones Cient\u00edficas, Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Raras, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5824-6973","authenticated-orcid":false,"given":"Enrique","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario 12 de Octubre , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Guill\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Cl\u00ednic, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de Espa\u00f1a, Department of Medicine, University of Barcelona , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0789-7992","authenticated-orcid":false,"given":"Miquel","family":"Blasco","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Hospital Cl\u00ednic, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de Espa\u00f1a, Department of Medicine, University of Barcelona , Barcelona , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rabasco","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Reina Sof\u00eda , C\u00f3rdoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Reina Sof\u00eda , C\u00f3rdoba, 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