Risk factors for acute kidney injury after brain hemorrhage
Acute kidney injury linked to higher rate of death within three months of intracerebral hemorrhage

Date:
October 5, 2020
Source:
University of Missouri-Columbia
Summary:
Patients who suffer an intracerebral hemorrhage (ICH) face
an increased risk of acute kidney injury (AKI) during their
hospitalization. AKI can lead to sudden kidney failure, kidney
damage or even death. Researchers have determined which ICH patients
are at the highest risk for this kidney injury so doctors can take
precautions to prevent it.



FULL STORY ========================================================================== Patients who suffer an intracerebral hemorrhage (ICH) face an increased
risk of acute kidney injury (AKI) during their hospitalization. AKI can
lead to sudden kidney failure, kidney damage or even death. Researchers
from the University of Missouri School of Medicine and MU Health Care
have determined which ICH patients are at the highest risk for this
kidney injury so doctors can take precautions to prevent it. They also
examined how the commonly-used blood pressure lowering drug nicardipine contributes to AKI.


========================================================================== "Over the past five years, clinicians have been concerned about AKI as
they see patients who present with ICH, then develop kidney failure and
require dialysis," said lead researcher Adnan I. Qureshi, MD, a professor
of clinical neurology at the MU School of Medicine. "What we need is a
more global body approach to improve the outcome of patients with ICH,
rather than just focusing on the brain." Qureshi's team analyzed data
from a multicenter trial in which 1,000 ICH patients with systolic blood pressure above 180 to either intensive (110-139 mm Hg) blood pressure
reduction or standard (140-179 mm Hg) reduction within 4.5 hours after
symptoms started. Researchers identified AKI by taking creatinine blood
samples -- which show how well the kidneys are functioning -- from each
patient for three days. They found 15% of all patients developed AKI,
higher doses of nicardipine were linked to an increased risk for AKI, and
a higher baseline serum creatinine level was associated with a greater
risk for AKI. In addition, those with AKI were nearly three times more
likely to die within three months of diagnosis.

"Even the initial set of labs seem to have predictive value in who will
develop AKI, and I think this study highlights the values doctors can
use to actually determine who may be at risk," Qureshi said. "What we
thought was an isolated brain disease, is not necessarily the case."
Qureshi believes the next step in preventing AKI after ICH is to use
serum creatinine and other markers to identify high-risk patients, then
use proactive measures to carefully manage intravenous fluids and avoid medications that are more likely to cause or worsen AKI.


========================================================================== Story Source: Materials provided by University_of_Missouri-Columbia. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Adnan I. Qureshi, Wei Huang, Iryna Lobanova, Daniel F. Hanley,
Chung Y.

Hsu, Kunal Malhotra, Thorsten Steiner, Jose I. Suarez, Kazunori
Toyoda, Haruko Yamamoto. Systolic Blood Pressure Reduction and
Acute Kidney Injury in Intracerebral Hemorrhage. Stroke, 2020; 51
(10): 3030 DOI: 10.1161/STROKEAHA.120.030272 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/10/201005112137.htm

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