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An Association Between Hyperchloremia and Acute Kidney Injury in Patients With Acute Ischemic Stroke
J Tyler Haller1, Keaton Smetana2, Michael J Erdman3
1Department of Pharmacy, Methodist University Hospital, Memphis, TN, USA.
The Neurohospitalist
|September 28, 2020
Summary
Moderate hyperchloremia (serum chloride ≥115 mmol/L) in patients with ischemic stroke is linked to a higher risk of acute kidney injury and longer hospital stays. Further research is needed to explore interventions and clinical outcomes.
Area of Science:
- Nephrology
- Neurology
- Critical Care Medicine
Background:
- Hyperchloremia is associated with adverse outcomes in hemorrhagic stroke.
- The relationship between hyperchloremia and outcomes in ischemic stroke remains unclear.
Purpose of the Study:
- To investigate the association between moderate hyperchloremia (serum chloride ≥115 mmol/L) and acute kidney injury (AKI) in patients with ischemic stroke.
- To explore the impact of hyperchloremia on mortality and hospital length of stay.
Main Methods:
- Multicenter, retrospective, propensity-matched cohort study.
- Inclusion of adult patients admitted for acute ischemic stroke.
- AKI diagnosis based on Acute Kidney Injury Network criteria.
Main Results:
- In the matched cohort (n=114), hyperchloremia was associated with an increased risk of AKI (RR 1.91).
- Patients with hyperchloremia experienced longer hospital stays (16 vs. 12 days, P=.03).
- Mortality was higher in the hyperchloremia group but did not reach statistical significance (19.3% vs. 10.5%).
Conclusions:
- Hyperchloremia following ischemic stroke is linked to elevated AKI rates and prolonged hospitalization.
- Further research is warranted to identify interventions for chloride level management and clarify the association with clinical outcomes.
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