Evaluation of the effect of hypernatremia on the development of acute kidney injury in patients with acute stroke admitted to intensive care unit

As acute stroke is a neurological emergency, it predisposes to the development of acute kidney injury due to comorbid conditions, hemodynamic instability, and use of contrast agents. In patients with acute stroke, hypernatremia may develop as a result of oral intake failure due to clouding of consci...

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Bibliographic Details
Published in:Journal of critical care 2024-06, Vol.81, p.154636, Article 154636
Main Authors: Kadiroglu, Ali Kemal, Karaarslan, Mehtap, Gumus, Mehmet Turan, Cevik, Mehmet Ugur
Format: Article
Language:English
Subjects:
Acute kidney injury
Acute stroke
Cardiovascular disease
Clinical outcomes
Comorbidity
Critical care
Hypernatremia
Intensive care unit
Kidney diseases
Mortality
Pathogenesis
Sodium
Stroke
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Summary:As acute stroke is a neurological emergency, it predisposes to the development of acute kidney injury due to comorbid conditions, hemodynamic instability, and use of contrast agents. In patients with acute stroke, hypernatremia may develop as a result of oral intake failure due to clouding of consciousness, fluid losses due to osmotic diuresis by mannitol and inappropriate fluid replacements. In this study, our aim is to evaluate the effect of hypernatremia on the development of acute kidney injury and clinical outcome in patients with acute stroke. In this study, 500 patients over the age of 18 and without chronic renal failure who were admitted to the Internal Medicine ICU and Neurology ICU in Medicine Faculty of Dicle University Hospital with the diagnosis of acute stroke between 2010 and 2016 were included. Patients data included demographic characteristics, cerebrovascular disease subtype, comorbid diseases, length of hospital stay, clinical outcome, serum sodium and creatinine values were obtained from the hospital information management system. AKI was defined according to the KDIGO criteria. Hypernatremia was determined by serum sodium value >145 mEq/L. The study population consisted of 52.6% female, 67.8% ischemic stroke. The distribution of comorbid diseases was showed in Table 1. Demographic, clinical and laboratory data of patients according to sodium status was showed in Table 2. Relationship between sodium status and AKI groups was showed in Table 3. The effect of hypernatremia on the development of AKI was found to increase 9.45 times. (Nagelkerke R square:0,462 p 
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2024.154636