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NEUROLOGY AND PSYCHIATRY

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ACUTE KIDNEY INJURY ON CLINICAL OUTCOMES IN ACUTE STROKE

A.M. Gerdt1, A.M. Shutov2, M.V. Menzorov2, Е.A. Gubareva1

1Tolyatti City Hospital № 2 named after V.V. Banykin,

2Ulyanovsk State University

 

The purpose of this study was to examine the incidence and severity of acute kidney injury (AKI) stroke patients discharged from hospital. The incidence of in-hospital AKI was 22 % in patients with stroke. AKI is associated with worse neurological deficit, recovery of neurological function. Among patients with acute kidney injury length of hospital stay higher than in the remaining patients.

Keywords: stroke, acute kidney injury, mobility index Rivermid, disability scale Rankin.

 

References

  1. Хроническая болезнь почек и фибрилляция предсердий у больных с хронической сердечной недостаточностью / А. М. Шутов [и др.] // Тер. архив. – 2009. – Т. 81, № 12. – С. 23–26.

  2. Acute kidney injury in hospitalized patients with decompensated heart failure / L. C. Barros [et al.] // J. Bras. Nefrol. – 2012. – Vol. 34, № 2. – P. 122–129.

  3. Acute kidney injury in severe trauma assessed by RIFLE criteria: a common feature without implications on mortality? / E. Gomes [et al.] // Scand. J. Trauma. Resusc. Emerg. Med. – 2010. – Vol. 18, № 1. – P. 34–39.

  4. Acute Kidney Injury is Associated with Increased Hospital Mortality after Stroke // M. Khatri [et al.] // J. Stroke Cerebrovasc Dis. – 2012. – Vol. 17. – P. 7.

  5. Acute kidney injury, length of stay, and costs in patients hospitalized in the intensive care unit / D. M. Vandijck [et al.] // Acta. Clin. Belg. Suppl. – 2007. – № 2. – P. 341–345.

  6. Acute renal failure in intensive care units-causes, outcome, and prognosis factors of hospital mortality. A prospective, multicenter study. French Study Group on Acute Renal Failure / F. Brivet [et al.] // Crit. Care Med. – 1996. – Vol. 24, № 2. – P. 192–198.

  7. Association between renal function and clinical outcome in patients with acute stroke / Z. Hao [et al.] // Eur. Neurol. – 2010. – Vol. 63, № 4. – P. 237–242.

  8. Bellomo R. Defining acute renal failure: physiological principles / R. Bellomo, J. A. Kellum, C. Ronco // Intensive Care Med. – 2004. – Vol. 30, № 1. – P. 33–37.

  9. Brott T. Measurements of acute cerebral infarction: a clinical examination scale / T. Brott, H. P. Adams, C. P. Olinger // Stroke. – 1989. – Vol. 20, № 7. – P. 864–870.

  10. Differential regulation of vascular cell adhesion molecule 1 gene transcription by tumor necrosis factor alpha and interleukin 1 alpha in dermal microvascular endothelial cells / J. Gille [et al.] // Blood. – 1996. – Vol. 87, № 1. – P. 211–217.

  11. Early changes in organ function predict eventual survival in severe sepsis / M. M. Levy [et al.] // Crit. Care Med. – 2005. – Vol. 33, № 10. – P. 2194–2201.

  12. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients / P. G. Metnitz [et al.] // Crit. Care Med. – 2002. – Vol. 30, № 9. – P. 2051–2058.

  13. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee: Guidelines for management of ischaemic stroke and transient ischaemic attack // Cerebrovasc. Dis. – 2008. – Vol. 25, № 5. – P. 457–507.

  14. Hospital-acquired renal insufficiency: a prospective study / S. H. Hou [et al.] // Am. J. Med. – 1983. – Vol. 74, № 2. – P. 243–248.

  15. In-hospital outcomes with thrombolytic therapy in patients with renal dysfunction presenting with acute ischaemicstroke / V. Agrawal [et al.] // Nephrol. Dial. Transplant. – 2010. – Vol. 25, № 4. – P. 1150–1157.

  16. KDIGO Clinical Practice Guidelines for Acute Kidney Injury // Kidney Int. – 2012. – Vol. 2. – 138 p.

  17. Nash K. Hospital-acquired renal insufficiency / K. Nash, A. Hafeez, S. Hou // Am. J. Kidney. Dis. – 2002. – Vol. 39, № 5. – P. 930–936.

  18. Palevsky P. M. Epidemiology of acute renal failure: the tip of the iceberg / P. M. Palevsky // Clin. J. Am. Soc. Nephrol. – 2006. – Vol. 1, № 1. – P. 6–7.

  19. Rankin J. Cerebral vascular accidents in patients over the age of 60: II. Prognosis / J. Rankin // Scott. Med. J. – 1957. – Vol. 2, № 5. – P. 200–215.

  20. Spectrum of acute renal failure in the intensive care unit: the PICARD experience / R. L. Mehta [et al.] // Kidney Int. – 2004. – Vol. 66, № 4. – P. 1613–1621.

  21. The impact of acute kidney injury on short-term survival in an Eastern European population with stroke / A. Covic [et al.] // Nephrol. Dial. Transplant. – 2008. – Vol. 23, № 7. – P. 2228–2234.

  22. The Rivermead Mobility Index: A further development of the Rivermead Motor Assessment / F. M. Collen [et al.] // Int. Disabil. Stud. – 1991. – Vol. 13, № 2. – P. 50–54.

  23. Tissue factor expression is differentially modulated by cyclic mechanical strain in various human endothelial cells / M. D. Silverman [et al.] // Blood Coagul. Fibrinolysis. – 1996. – Vol. 7, № 3. – P. 281–288.

  24. Toyoda K. Cerebrorenal interaction and stroke / K. Toyoda // Contrib. Nephrol. – 2013. – Vol. 179. – P. 1–6.

 

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УДК 615.835.14.015

ВЛИЯНИЕ ОСТРОГО ПОВРЕЖДЕНИЯ ПОЧЕК НА ДЛИТЕЛЬНОСТЬ ГОСПИТАЛИЗАЦИИ И ВОССТАНОВЛЕНИЕ НЕВРОЛОГИЧЕСКОГО ДЕФИЦИТА В ОСТРЫЙ ПЕРИОД ИНСУЛЬТА

А.М. Гердт1, А.М. Шутов2, М.В. Мензоров2, Е.А. Губарева1

1Тольяттинская городская больница № 2 им. В.В. Баныкина,

2Ульяновский государственный университет

 

В работе проведен анализ частоты и выраженности острого повреждения почек (ОПП) у больных с инсультом, выписанных из стационара. Установлено, что каждый пятый больной в острый период инсульта имел острое повреждение почек. У больных с ОПП неврологический дефицит и неврологические функции восстанавливаются хуже, чем у пациентов без ОПП. Среди больных с острым повреждением почек длительность госпитализации выше, чем у больных без ОПП.

Ключевые слова: инсульт, острое повреждение почек, индекс мобильности Ривермид, шкала инвалидизации Ranki.

 

Литература

  1. Хроническая болезнь почек и фибрилляция предсердий у больных с хронической сердечной недостаточностью / А. М. Шутов [и др.] // Тер. архив. – 2009. – Т. 81, № 12. – С. 23–26.

  2. Acute kidney injury in hospitalized patients with decompensated heart failure / L. C. Barros [et al.] // J. Bras. Nefrol. – 2012. – Vol. 34, № 2. – P. 122–129.

  3. Acute kidney injury in severe trauma assessed by RIFLE criteria: a common feature without implications on mortality? / E. Gomes [et al.] // Scand. J. Trauma. Resusc. Emerg. Med. – 2010. – Vol. 18, № 1. – P. 34–39.

  4. Acute Kidney Injury is Associated with Increased Hospital Mortality after Stroke // M. Khatri [et al.] // J. Stroke Cerebrovasc Dis. – 2012. – Vol. 17. – P. 7.

  5. Acute kidney injury, length of stay, and costs in patients hospitalized in the intensive care unit / D. M. Vandijck [et al.] // Acta. Clin. Belg. Suppl. – 2007. – № 2. – P. 341–345.

  6. Acute renal failure in intensive care units-causes, outcome, and prognosis factors of hospital mortality. A prospective, multicenter study. French Study Group on Acute Renal Failure / F. Brivet [et al.] // Crit. Care Med. – 1996. – Vol. 24, № 2. – P. 192–198.

  7. Association between renal function and clinical outcome in patients with acute stroke / Z. Hao [et al.] // Eur. Neurol. – 2010. – Vol. 63, № 4. – P. 237–242.

  8. Bellomo R. Defining acute renal failure: physiological principles / R. Bellomo, J. A. Kellum, C. Ronco // Intensive Care Med. – 2004. – Vol. 30, № 1. – P. 33–37.

  9. Brott T. Measurements of acute cerebral infarction: a clinical examination scale / T. Brott, H. P. Adams, C. P. Olinger // Stroke. – 1989. – Vol. 20, № 7. – P. 864–870.

  10. Differential regulation of vascular cell adhesion molecule 1 gene transcription by tumor necrosis factor alpha and interleukin 1 alpha in dermal microvascular endothelial cells / J. Gille [et al.] // Blood. – 1996. – Vol. 87, № 1. – P. 211–217.

  11. Early changes in organ function predict eventual survival in severe sepsis / M. M. Levy [et al.] // Crit. Care Med. – 2005. – Vol. 33, № 10. – P. 2194–2201.

  12. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients / P. G. Metnitz [et al.] // Crit. Care Med. – 2002. – Vol. 30, № 9. – P. 2051–2058.

  13. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee: Guidelines for management of ischaemic stroke and transient ischaemic attack // Cerebrovasc. Dis. – 2008. – Vol. 25, № 5. – P. 457–507.

  14. Hospital-acquired renal insufficiency: a prospective study / S. H. Hou [et al.] // Am. J. Med. – 1983. – Vol. 74, № 2. – P. 243–248.

  15. In-hospital outcomes with thrombolytic therapy in patients with renal dysfunction presenting with acute ischaemicstroke / V. Agrawal [et al.] // Nephrol. Dial. Transplant. – 2010. – Vol. 25, № 4. – P. 1150–1157.

  16. KDIGO Clinical Practice Guidelines for Acute Kidney Injury // Kidney Int. – 2012. – Vol. 2. – 138 p.

  17. Nash K. Hospital-acquired renal insufficiency / K. Nash, A. Hafeez, S. Hou // Am. J. Kidney. Dis. – 2002. – Vol. 39, № 5. – P. 930–936.

  18. Palevsky P. M. Epidemiology of acute renal failure: the tip of the iceberg / P. M. Palevsky // Clin. J. Am. Soc. Nephrol. – 2006. – Vol. 1, № 1. – P. 6–7.

  19. Rankin J. Cerebral vascular accidents in patients over the age of 60: II. Prognosis / J. Rankin // Scott. Med. J. – 1957. – Vol. 2, № 5. – P. 200–215.

  20. Spectrum of acute renal failure in the intensive care unit: the PICARD experience / R. L. Mehta [et al.] // Kidney Int. – 2004. – Vol. 66, № 4. – P. 1613–1621.

  21. The impact of acute kidney injury on short-term survival in an Eastern European population with stroke / A. Covic [et al.] // Nephrol. Dial. Transplant. – 2008. – Vol. 23, № 7. – P. 2228–2234.

  22. The Rivermead Mobility Index: A further development of the Rivermead Motor Assessment / F. M. Collen [et al.] // Int. Disabil. Stud. – 1991. – Vol. 13, № 2. – P. 50–54.

  23. Tissue factor expression is differentially modulated by cyclic mechanical strain in various human endothelial cells / M. D. Silverman [et al.] // Blood Coagul. Fibrinolysis. – 1996. – Vol. 7, № 3. – P. 281–288.

  24. Toyoda K. Cerebrorenal interaction and stroke / K. Toyoda // Contrib. Nephrol. – 2013. – Vol. 179. – P. 1–6.