Risk factors for acute kidney injury after intracranial hemorrhage.

IF 0.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM Neuro endocrinology letters Pub Date : 2022-12-20

Huishui Dai, Feng Ding, Jiawei Ma, Shibing Zhao

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Abstract

Objective: This study investigated the risk factors for acute kidney injury (AKI) occurrence in patients with spontaneous intracerebral hemorrhage.

Methods: The clinical data of patients with spontaneous intracerebral hemorrhage who were hospitalized in the Department of Intensive Care Medicine of Mingguang People's Hospital from January 2016 to August 2020 were retrospectively analyzed. The patients were divided into AKI group and non-AKI group according to whether the patient had secondary AKI, and the clinical data of the two groups were compared. Logistic regression analysis was used to screen out the risk factors for secondary AKI in patients with spontaneous intracerebral hemorrhage.

Results: Three hundred thirty-seven patients were included in this study, whereby 186 males (55.2%) and 151 females (44.8%). A total of 65 patients developed AKI, of whom 44 patients were (67.69%) in stage 1, 12 patients (18.46%) in stage 2, and 9 patients (13.85%) in stage 3. Univariate logistic regression analysis showed that Acute Physiology, Age and Chronic Health Evaluation (APACHE II score), diabetes, chronic kidney disease, fasting blood glucose level and amount of mannitol used were risk factors for AKI in patients with intracerebral hemorrhage. Multivariate logistic regression analysis showed APACHE II score (OR: 1.846, 95% CI: 1.319 to 2.585, p < 0.001), diabetes (OR: 3.609, 95% CI: 1.596 to 8.163, p=0.002) and amount of mannitol use (OR: 3.495, 95% CI: 1.910~3.395, p < 0.001) are the independent risk factors for AKI after intracranial hemorrhage.

Conclusion: In summary, APACHE II score, diabetes, and total mannitol use are independent risk factors for AKI in patients with spontaneous intracerebral hemorrhage. It is necessary to monitor renal function frequently in patients with high APACHE II scores and control the amount of mannitol administrated in the prevention of AKI after intracranial hemorrhage. The intervention of the above factors is expected to reduce the risk of secondary AKI.

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颅内出血后急性肾损伤的危险因素。

目的:探讨自发性脑出血患者发生急性肾损伤(AKI)的危险因素。方法:回顾性分析2016年1月至2020年8月在明光人民医院重症医学科住院的自发性脑出血患者的临床资料。根据患者是否有继发性AKI分为AKI组和非AKI组，比较两组的临床资料。采用Logistic回归分析筛选自发性脑出血患者继发AKI的危险因素。结果:共纳入337例患者，其中男性186例(55.2%)，女性151例(44.8%)。65例患者发生AKI，其中1期44例(67.69%)，2期12例(18.46%)，3期9例(13.85%)。单因素logistic回归分析显示，急性生理、年龄和慢性健康评估(APACHE II评分)、糖尿病、慢性肾病、空腹血糖水平和甘露醇用量是脑出血患者发生AKI的危险因素。多因素logistic回归分析显示，APACHEⅱ评分(OR: 1.846, 95% CI: 1.319 ~ 2.585, p < 0.001)、糖尿病(OR: 3.609, 95% CI: 1.596 ~ 8.163, p=0.002)、甘露醇用量(OR: 3.495, 95% CI: 1.910~3.395, p < 0.001)是颅内出血后AKI的独立危险因素。结论:总之，APACHE II评分、糖尿病和总甘露醇的使用是自发性脑出血患者AKI的独立危险因素。对于APACHEⅱ评分较高的患者，应经常监测肾功能，控制甘露醇的用量，以预防颅内出血后AKI的发生。上述因素的干预有望降低继发性AKI的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuro endocrinology letters 医学-内分泌学与代谢

CiteScore

1.00

自引率

14.30%

发文量

审稿时长

6 months

期刊介绍： Neuroendocrinology Letters is an international, peer-reviewed interdisciplinary journal covering the fields of Neuroendocrinology, Neuroscience, Neurophysiology, Neuropsychopharmacology, Psychoneuroimmunology, Reproductive Medicine, Chronobiology, Human Ethology and related fields for RAPID publication of Original Papers, Review Articles, State-of-the-art, Clinical Reports and other contributions from all the fields covered by Neuroendocrinology Letters. Papers from both basic research (methodology, molecular and cellular biology, anatomy, histology, biology, embryology, teratology, normal and pathological physiology, biophysics, pharmacology, pathology and experimental pathology, biochemistry, neurochemistry, enzymology, chronobiology, receptor studies, endocrinology, immunology and neuroimmunology, animal physiology, animal breeding and ethology, human ethology, psychology and others) and from clinical research (neurology, psychiatry and child psychiatry, obstetrics and gynecology, pediatrics, endocrinology, immunology, cardiovascular studies, internal medicine, oncology and others) will be considered. The Journal publishes Original papers and Review Articles. Brief reports, Special Communications, proved they are based on adequate experimental evidence, Clinical Studies, Case Reports, Commentaries, Discussions, Letters to the Editor (correspondence column), Book Reviews, Congress Reports and other categories of articles (philosophy, art, social issues, medical and health policies, biomedical history, etc.) will be taken under consideration.