Transient renal impairment in acute intracerebral haemorrhage

Transient impairment of renal function was found in 30 of 78 patients with acute intracerebral haemorrhage (ICH). Patients with a history of renal disease, dehydration, nephrotoxic drugs or septicaemia were excluded. In the 1st week, the mean serum creatinine level was 3.4 (range 1.7-7.7) mg/dl, which returned to normal in 2-4 weeks. Employing multivariate stepdown logistic regression analysis, Glasgow Coma Scale score and pulse pressure were found to be significantly related to renal impairment manifesting with a raised serum creatinine level, whereas pupillary asymmetry was of borderline significance. An acute rise in intracranial pressure following ICH may result in sympathetic overactivity, which may account for the renal impairment observed in our patients.