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...

Full description

Saved in:
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
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page
container_issue
container_start_page 154636
container_title Journal of critical care
container_volume 81
creator Kadiroglu, Ali Kemal
Karaarslan, Mehtap
Gumus, Mehmet Turan
Cevik, Mehmet Ugur
description 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 
doi_str_mv 10.1016/j.jcrc.2024.154636
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_3020341848</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0883944124001230</els_id><sourcerecordid>3020341848</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1248-8a0d41839190012e70f60137ba388bf807c1ef79229d8cadf49756d1244761df3</originalsourceid><addsrcrecordid>eNp9kMtKxDAUhoMoOF5ewFXAdcekSdsU3MjgDQQ3ug4xOWFSZ5qapJV5DN_Y1Jm1q8Mh3_-T8yF0RcmSElrfdMtOB70sScmXtOI1q4_QglZVU4iaVsdoQYRgRcs5PUVnMXaE0IaxaoF-7ie1GVVyvsfe4rQGDNaCTvO23g0QepUCbJ3CmZifDUyw8cMW-j9G6TEB_nSmhx12fTeGeeAhV2Yi4m-X1gcopuA_ASuzdSmBwclnMkEf3QRYqwB47F26QCdWbSJcHuY5en-4f1s9FS-vj8-ru5dC05KLQihiOBWspW0-poSG2JpQ1nwoJsSHFaTRFGzTlmVrhFbG8rapapOzvKmpsewcXe97h-C_RohJdn7M126iZKQkLJdzkalyT-ngYwxg5RDcVoWdpETO6mUnZ_VyVi_36nPodh-C_P_JQZBRZxsajAtZrTTe_Rf_BQz3jm8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3020341848</pqid></control><display><type>article</type><title>Evaluation of the effect of hypernatremia on the development of acute kidney injury in patients with acute stroke admitted to intensive care unit</title><source>ScienceDirect Journals</source><creator>Kadiroglu, Ali Kemal ; Karaarslan, Mehtap ; Gumus, Mehmet Turan ; Cevik, Mehmet Ugur</creator><creatorcontrib>Kadiroglu, Ali Kemal ; Karaarslan, Mehtap ; Gumus, Mehmet Turan ; Cevik, Mehmet Ugur</creatorcontrib><description>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 &gt;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 &lt; 0,001 OR:9,45%95 CI 5,66-15,79). While the mortality rate was 75% in the hypernatremic group, it was 25.33% in the isonatremic group was showed in Table 4. By logistic regression analysis, it was found that hypernatremia increased mortality 8.8 times.(nagelkerke R square:0,294 p &lt; 0,001 OR:8,8%95 CI 5,85 -13,35). 72.41% of patients who developed AKI and 34.08% of patients who did not develop AKI died (p &lt; 0.001) was showed in Table 5. AKI was found to increase mortality by 5.07 times (Nagelkerke R square:0,156 p &lt; 0,001 OR:5,07%95 CI 3,31–7,76). The presence of hypernatremia in patients followed up with the diagnosis of acute stroke in the intensive care unit is a serious clinical condition that increases the development of AKI and mortality. Therefore, identifying high-risk patients among acute stroke patients, closely monitoring hypernatremia, preventing the development of AKI, and improving treatment modalities will contribute to a significant reduction in mortality.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2024.154636</identifier><language>eng</language><publisher>Philadelphia: Elsevier Inc</publisher><subject>Acute kidney injury ; Acute stroke ; Cardiovascular disease ; Clinical outcomes ; Comorbidity ; Critical care ; Hypernatremia ; Intensive care unit ; Kidney diseases ; Mortality ; Pathogenesis ; Sodium ; Stroke</subject><ispartof>Journal of critical care, 2024-06, Vol.81, p.154636, Article 154636</ispartof><rights>2024</rights><rights>Copyright Elsevier Limited Jun 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Kadiroglu, Ali Kemal</creatorcontrib><creatorcontrib>Karaarslan, Mehtap</creatorcontrib><creatorcontrib>Gumus, Mehmet Turan</creatorcontrib><creatorcontrib>Cevik, Mehmet Ugur</creatorcontrib><title>Evaluation of the effect of hypernatremia on the development of acute kidney injury in patients with acute stroke admitted to intensive care unit</title><title>Journal of critical care</title><description>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 &gt;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 &lt; 0,001 OR:9,45%95 CI 5,66-15,79). While the mortality rate was 75% in the hypernatremic group, it was 25.33% in the isonatremic group was showed in Table 4. By logistic regression analysis, it was found that hypernatremia increased mortality 8.8 times.(nagelkerke R square:0,294 p &lt; 0,001 OR:8,8%95 CI 5,85 -13,35). 72.41% of patients who developed AKI and 34.08% of patients who did not develop AKI died (p &lt; 0.001) was showed in Table 5. AKI was found to increase mortality by 5.07 times (Nagelkerke R square:0,156 p &lt; 0,001 OR:5,07%95 CI 3,31–7,76). The presence of hypernatremia in patients followed up with the diagnosis of acute stroke in the intensive care unit is a serious clinical condition that increases the development of AKI and mortality. Therefore, identifying high-risk patients among acute stroke patients, closely monitoring hypernatremia, preventing the development of AKI, and improving treatment modalities will contribute to a significant reduction in mortality.</description><subject>Acute kidney injury</subject><subject>Acute stroke</subject><subject>Cardiovascular disease</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Critical care</subject><subject>Hypernatremia</subject><subject>Intensive care unit</subject><subject>Kidney diseases</subject><subject>Mortality</subject><subject>Pathogenesis</subject><subject>Sodium</subject><subject>Stroke</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kMtKxDAUhoMoOF5ewFXAdcekSdsU3MjgDQQ3ug4xOWFSZ5qapJV5DN_Y1Jm1q8Mh3_-T8yF0RcmSElrfdMtOB70sScmXtOI1q4_QglZVU4iaVsdoQYRgRcs5PUVnMXaE0IaxaoF-7ie1GVVyvsfe4rQGDNaCTvO23g0QepUCbJ3CmZifDUyw8cMW-j9G6TEB_nSmhx12fTeGeeAhV2Yi4m-X1gcopuA_ASuzdSmBwclnMkEf3QRYqwB47F26QCdWbSJcHuY5en-4f1s9FS-vj8-ru5dC05KLQihiOBWspW0-poSG2JpQ1nwoJsSHFaTRFGzTlmVrhFbG8rapapOzvKmpsewcXe97h-C_RohJdn7M126iZKQkLJdzkalyT-ngYwxg5RDcVoWdpETO6mUnZ_VyVi_36nPodh-C_P_JQZBRZxsajAtZrTTe_Rf_BQz3jm8</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Kadiroglu, Ali Kemal</creator><creator>Karaarslan, Mehtap</creator><creator>Gumus, Mehmet Turan</creator><creator>Cevik, Mehmet Ugur</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>202406</creationdate><title>Evaluation of the effect of hypernatremia on the development of acute kidney injury in patients with acute stroke admitted to intensive care unit</title><author>Kadiroglu, Ali Kemal ; Karaarslan, Mehtap ; Gumus, Mehmet Turan ; Cevik, Mehmet Ugur</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1248-8a0d41839190012e70f60137ba388bf807c1ef79229d8cadf49756d1244761df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute kidney injury</topic><topic>Acute stroke</topic><topic>Cardiovascular disease</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Critical care</topic><topic>Hypernatremia</topic><topic>Intensive care unit</topic><topic>Kidney diseases</topic><topic>Mortality</topic><topic>Pathogenesis</topic><topic>Sodium</topic><topic>Stroke</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kadiroglu, Ali Kemal</creatorcontrib><creatorcontrib>Karaarslan, Mehtap</creatorcontrib><creatorcontrib>Gumus, Mehmet Turan</creatorcontrib><creatorcontrib>Cevik, Mehmet Ugur</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Databases</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kadiroglu, Ali Kemal</au><au>Karaarslan, Mehtap</au><au>Gumus, Mehmet Turan</au><au>Cevik, Mehmet Ugur</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of the effect of hypernatremia on the development of acute kidney injury in patients with acute stroke admitted to intensive care unit</atitle><jtitle>Journal of critical care</jtitle><date>2024-06</date><risdate>2024</risdate><volume>81</volume><spage>154636</spage><pages>154636-</pages><artnum>154636</artnum><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>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 &gt;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 &lt; 0,001 OR:9,45%95 CI 5,66-15,79). While the mortality rate was 75% in the hypernatremic group, it was 25.33% in the isonatremic group was showed in Table 4. By logistic regression analysis, it was found that hypernatremia increased mortality 8.8 times.(nagelkerke R square:0,294 p &lt; 0,001 OR:8,8%95 CI 5,85 -13,35). 72.41% of patients who developed AKI and 34.08% of patients who did not develop AKI died (p &lt; 0.001) was showed in Table 5. AKI was found to increase mortality by 5.07 times (Nagelkerke R square:0,156 p &lt; 0,001 OR:5,07%95 CI 3,31–7,76). The presence of hypernatremia in patients followed up with the diagnosis of acute stroke in the intensive care unit is a serious clinical condition that increases the development of AKI and mortality. Therefore, identifying high-risk patients among acute stroke patients, closely monitoring hypernatremia, preventing the development of AKI, and improving treatment modalities will contribute to a significant reduction in mortality.</abstract><cop>Philadelphia</cop><pub>Elsevier Inc</pub><doi>10.1016/j.jcrc.2024.154636</doi></addata></record>
fulltext fulltext
identifier ISSN: 0883-9441
ispartof Journal of critical care, 2024-06, Vol.81, p.154636, Article 154636
issn 0883-9441
1557-8615
language eng
recordid cdi_proquest_journals_3020341848
source ScienceDirect Journals
subjects Acute kidney injury
Acute stroke
Cardiovascular disease
Clinical outcomes
Comorbidity
Critical care
Hypernatremia
Intensive care unit
Kidney diseases
Mortality
Pathogenesis
Sodium
Stroke
title Evaluation of the effect of hypernatremia on the development of acute kidney injury in patients with acute stroke admitted to intensive care unit
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T22%3A14%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluation%20of%20the%20effect%20of%20hypernatremia%20on%20the%20development%20of%20acute%20kidney%20injury%20in%20patients%20with%20acute%20stroke%20admitted%20to%20intensive%20care%20unit&rft.jtitle=Journal%20of%20critical%20care&rft.au=Kadiroglu,%20Ali%20Kemal&rft.date=2024-06&rft.volume=81&rft.spage=154636&rft.pages=154636-&rft.artnum=154636&rft.issn=0883-9441&rft.eissn=1557-8615&rft_id=info:doi/10.1016/j.jcrc.2024.154636&rft_dat=%3Cproquest_cross%3E3020341848%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c1248-8a0d41839190012e70f60137ba388bf807c1ef79229d8cadf49756d1244761df3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3020341848&rft_id=info:pmid/&rfr_iscdi=true