Department of Critical Care Medicine, Mingguang People's Hospital, Mingguang, Anhui, 239400, China.
Department of Critical Care Medicine, The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, 214002, China.
Neuro Endocrinol Lett. 2022 Dec 20;43(5):257-264.
This study investigated the risk factors for acute kidney injury (AKI) occurrence in patients with spontaneous intracerebral hemorrhage.
The clinical data of patients with spontaneous intracerebral hemorrhage who were hospitalized in the Department of Intensive Care Medicine of Mingguang People's Hospital from January 2016 to August 2020 were retrospectively analyzed. The patients were divided into AKI group and non-AKI group according to whether the patient had secondary AKI, and the clinical data of the two groups were compared. Logistic regression analysis was used to screen out the risk factors for secondary AKI in patients with spontaneous intracerebral hemorrhage.
Three hundred thirty-seven patients were included in this study, whereby 186 males (55.2%) and 151 females (44.8%). A total of 65 patients developed AKI, of whom 44 patients were (67.69%) in stage 1, 12 patients (18.46%) in stage 2, and 9 patients (13.85%) in stage 3. Univariate logistic regression analysis showed that Acute Physiology, Age and Chronic Health Evaluation (APACHE II score), diabetes, chronic kidney disease, fasting blood glucose level and amount of mannitol used were risk factors for AKI in patients with intracerebral hemorrhage. Multivariate logistic regression analysis showed APACHE II score (OR: 1.846, 95% CI: 1.319 to 2.585, p < 0.001), diabetes (OR: 3.609, 95% CI: 1.596 to 8.163, p=0.002) and amount of mannitol use (OR: 3.495, 95% CI: 1.910~3.395, p < 0.001) are the independent risk factors for AKI after intracranial hemorrhage.
In summary, APACHE II score, diabetes, and total mannitol use are independent risk factors for AKI in patients with spontaneous intracerebral hemorrhage. It is necessary to monitor renal function frequently in patients with high APACHE II scores and control the amount of mannitol administrated in the prevention of AKI after intracranial hemorrhage. The intervention of the above factors is expected to reduce the risk of secondary AKI.
本研究旨在探讨自发性脑出血患者发生急性肾损伤（AKI）的危险因素。
回顾性分析 2016 年 1 月至 2020 年 8 月在明光市人民医院重症医学科住院的自发性脑出血患者的临床资料。根据患者是否发生继发性 AKI 将其分为 AKI 组和非 AKI 组，比较两组患者的临床资料。采用 Logistic 回归分析筛选自发性脑出血患者继发性 AKI 的危险因素。
本研究共纳入 337 例患者，其中男 186 例（55.2%），女 151 例（44.8%）。共 65 例患者发生 AKI，其中 1 期 44 例（67.69%），2 期 12 例（18.46%），3 期 9 例（13.85%）。单因素 logistic 回归分析显示，急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ评分）、糖尿病、慢性肾脏病、空腹血糖水平和甘露醇用量是脑出血患者 AKI 的危险因素。多因素 logistic 回归分析显示，APACHEⅡ评分（OR：1.846，95%CI：1.3192.585，p<0.001）、糖尿病（OR：3.609，95%CI：1.5968.163，p=0.002）和甘露醇用量（OR：3.495，95%CI：1.910~3.395，p<0.001）是脑出血后 AKI 的独立危险因素。
综上所述，APACHEⅡ评分、糖尿病和甘露醇总用量是自发性脑出血患者发生 AKI 的独立危险因素。对于 APACHEⅡ评分较高的患者，需要频繁监测肾功能，并控制甘露醇的用量，以预防脑出血后 AKI 的发生。干预上述因素有望降低继发性 AKI 的风险。
