Острое повреждение почек у больных с инсультом

Abstract

AIM. The aim of this study was to assess the incidence and severity of the acute kidney injury (AKI) in patients with stroke and investigate the relationship between AKI and in-hospital mortality. PATIENTS AND METHODS. 98 patients (54 (55%) men and 44 (45%) women, mean age was 63±11 years) with acute stroke were studied. Diagnosis was confirmed by tomography. 66 (67%) patients had ischemic stroke and 32 (33%) - hemorrhagic stroke . AKI was defined according to KDIGO Guidelines (2012). RESULTS. AKI was revealed in 30 patients (31%): 19 (20%) with first stage, 6 (6%) with stage 2 and 5 (5%) with stage 3. The incidence of AKI was significantly higher in patients with hemorrhagic stroke, than with ischemic stroke (50% and 21%, respectively, p=0,004). The AKI patients had a higher NIHSS (National Institutes of Health Stroke Scale) severity scores (p=0,001) and lower Rivermed mobility index (p=0,0007) compared with patients without AKI. Previous chronic heart failure was the independent predictor of AKI (relative risk 6.7, 95% confidence intervals 1.8 to 20.0). The in-hospital mortality rate was 18%. AKI was independent predictor of in-hospital mortality (relative risk 5.4, 95% confidence intervals 1.5 to 19.3). CONCLUSIONS. Our results show that the incidence of AKI in patients with acute stroke is 31%. The ischemic stroke patients had a twice higher rate of AKI compared with hemorrhagic stroke patients. Previous chronic heart failure was the predictor of AKI. AKI was significantly associated with in-hospital mortality.