Risk factors for acute kidney injury after intracranial hemorrhage

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

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.

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.

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.