Brain Hemorrhage Increases the Risk of Acute Kidney Injury

Patients who suffer from brain hemorrhage have an increased risk of acute kidney injury (AKI) during their hospitalization, reveals a new study. AKI can lead to sudden kidney damage, kidney failure, or even death. Researchers have determined which intracerebral hemorrhage (ICH) patients are at the highest risk for this kidney injury so physicians can take precautions to prevent it. They also studied how the commonly-used blood pressure-lowering medicine nicardipine contributes to AKI. The findings of the study are published in the journal Stroke.

"Over the past 5 years, clinicians have been bothered about AKI as they see patients who present with brain injury, later develop kidney failure and need dialysis," stated lead researcher Adnan I. Qureshi. "What we require is a more global body method to improve patients' outcome with ICH, rather than just concentrating on the brain."

‘Acute kidney injury is linked to a higher rate of death within three months of a brain hemorrhage. ’

Qureshi's team identified data from a multicenter trial in which 1,000 brain injury patients with systolic blood pressure more than 180 to either standard (140-179 mm Hg) blood pressure reduction or intensive (110-139 mm Hg) reduction within 4.5 hours after symptoms began. Researchers identified kidney injury by taking creatinine blood samples, which determine how well the kidneys are functioning from each patient for three days.

They found 15 percent of all patients developed AKI, higher doses of nicardipine were associated with an increased risk for acute kidney injury, and a higher baseline serum creatinine level was linked to a greater risk for acute kidney injury. In addition, those with acute kidney injury were nearly 3 times more likely to die within three months of diagnosis.

"Even the first set of labs appear to have predictive value in who will develop acute kidney injury, and I think this study highlights the values doctors can use actually to determine who may be at risk," Qureshi stated.

Qureshi believes the next step in preventing kidney injury after brain injury is to use serum creatinine and other markers to recognize high-risk patients, then use proactive steps to carefully manage intravenous fluids and avoid prescriptions that are more likely to cause or worsen AKI.

Source: Medindia