Acute kidney injury in patients with malignant middle cerebral artery infarction undergoing hyperosmolar therapy with mannitol

Moustafa, Haidar; Schoene, Daniela; Altarsha, Eyad; Rahmig, Jan; Schneider, Hauke; Pallesen, Lars-Peder; Prakapenia, Alexandra; Siepmann, Timo; Barlinn, Jessica; Passauer, Jens; Reichmann, Heinz; Puetz, Volker; Barlinn, Kristian

doi:10.1016/j.jcrc.2021.02.007

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…In the present retrospective study, we found that SII values on admission weakly predicted the development of AKI in patients with SCH who underwent craniotomy and that SII could predict the outcomes of these patients with AKI. A high incidence rate of AKI (42.3%) was observed in our cohort, which was consistent with other reports of neurological intensive scenarios [ 25 , 26 ] and postoperative patients in ICUs [ 27 ]. Inflammatory cell infiltration and mediated inflammation in the kidneys are mechanisms of AKI.…”

Section: Discussionsupporting

confidence: 93%

Systemic immune-inflammation index may predict the acute kidney injury and prognosis in patients with spontaneous cerebral hemorrhage undergoing craniotomy: a single-center retrospective study

Wang

Sun

et al. 2023

BMC Nephrol

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Background The systemic immune-inflammation index (SII) is an emerging prognostic marker of cancer. We aimed to explore the predictive ability of the SII on acute kidney injury (AKI) and prognosis in patients with spontaneous cerebral hemorrhage (SCH) who underwent craniotomy. Methods Patients with SCH who underwent craniotomy between 2014 and 2021 were enrolled in this study. The epidemiology and predictive factors for AKI after SCH were analyzed. The prognostic factors for clinical outcomes in patients with SCH and AKI were further investigated. The prognostic factors were then analyzed using a logistic regression model and a receiver operating characteristic curve. Results In total, 305 patients were enrolled in this study. Of these, 129 (42.3%) patients presented with AKI, and 176 (57.7%) patients were unremarkable. The SII (odds ratio [OR], 1.261; 95% confidence interval [CI], 1.036–1.553; P = 0.020) values and serum uric acid levels (OR, 1.004; 95% CI, 1.001–1.007; P = 0.005) were significant predictors of AKI after SCH craniotomy. The SII cutoff value was 1794.43 (area under the curve [AUC], 0.669; 95% CI, 0.608–0.730; P < 0.001; sensitivity, 65.9%; specificity, 65.1%). Of the patients with AKI, 95 and 34 achieved poor and good outcomes, respectively. SII values (OR, 2.667; 95% CI, 1.167–6.095; P = 0.020), systemic inflammation response index values (OR, 1.529; 95% CI, 1.064–2.198; P = 0.022), and Glasgow Coma Scale (GCS) scores on admission (OR, 0.593; 95% CI, 0.437–0.805; P = 0.001) were significant in the multivariate logistic regression analysis. The cutoff SII value was 2053.51 (AUC, 0.886; 95% CI, 0.827–0.946; P < 0.001; sensitivity, 78.9%; specificity, 88.2%). Conclusions The SII may predict AKI in patients with SCH who underwent craniotomy and may also predict the short-term prognosis of these patients.

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Section: Discussionsupporting

confidence: 93%

Systemic immune-inflammation index may predict the acute kidney injury and prognosis in patients with spontaneous cerebral hemorrhage undergoing craniotomy: a single-center retrospective study

Wang

Sun

et al. 2023

BMC Nephrol

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“…This pathology is commonly known as “osmotic nephrosis” or “sucrose nephrosis” ( Figure 3 ). Several studies showed that intravenous administration of immune globulin, mannitol, contrast media, hydroxyethyl starch solutions, or glucose can induce AKI injury via osmotic cell destruction [ 59 , 60 , 61 , 62 , 63 , 64 , 65 ]. It was well-documented that osmotically active agents entered the tubular cells by means of pinocytosis, leading to cellular edema with increased lysosomes and endocytotic vacuoles.…”

Section: Plasma Hyperosmolality and The Kidneymentioning

confidence: 99%

“…Several studies documented AKI following mannitol administration [ 62 , 69 , 70 , 71 ]. Mannitol-induced osmotic nephrosis has been well-documented, as it exerts nephrotoxic activity [ 61 , 62 , 63 , 65 , 72 ]. There is a dose–response relationship between the use of mannitol and the incidence and severity of AKI, with a cut-off of the daily dose at 1.34 g/kg body weight [ 73 ].…”

Section: Plasma Hyperosmolality and The Kidneymentioning

confidence: 99%

“…Clinical observations documented a significant relationship between plasma osmolality and a higher incidence of AKI noted in patients with diabetic ketoacidosis when osmolality exceeded 320 mOsm/kg [67,68]. The osmotic nephrosis is usually reversible after discontinuation of osmotically active agents; however, some patients require temporary renal replacement therapy [63,[68][69][70][71]. Mannitol is not recommended for use in the management of severe TBI when ICP and brain tissue oxygen are monitored [2].…”

Section: Plasma Hyperosmolality and The Kidneymentioning

confidence: 99%

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Potentially Detrimental Effects of Hyperosmolality in Patients Treated for Traumatic Brain Injury

Dąbrowski

Siwicka-Gieroba

Robba

et al. 2021

JCM

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Hyperosmotic therapy is commonly used to treat intracranial hypertension in traumatic brain injury patients. Unfortunately, hyperosmolality also affects other organs. An increase in plasma osmolality may impair kidney, cardiac, and immune function, and increase blood–brain barrier permeability. These effects are related not only to the type of hyperosmotic agents, but also to the level of hyperosmolality. The commonly recommended osmolality of 320 mOsm/kg H2O seems to be the maximum level, although an increase in plasma osmolality above 310 mOsm/kg H2O may already induce cardiac and immune system disorders. The present review focuses on the adverse effects of hyperosmolality on the function of various organs.

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“…And compared with CT, MRI has a higher resolution, but requires more time to perform. In addition, if the medication time is too long after the use of ICP reduction treatment, excessive use of ICP reduction drugs may cause renal impairment (Moustafa et al, 2021), central pontine myelinolysis, and rebound internal hypertension exists (Qureshi and Suarez, 2000). Therefore, the development of non-invasive dynamic monitoring of ICP is of great significance for patients with AIS.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonic optic nerve sheath diameter could improve the prognosis of acute ischemic stroke in the intensive care unit

et al. 2022

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Objectives: Stroke patients with high intracranial pressure (ICP) may have poor prognosis. Non-invasive ultrasonic optic nerve sheath diameter (ONSD) could evaluate increased ICP. To investigate whether ONSD is valuable for prognosis of patients with acute ischemic stroke (AIS).Methods: AIS receiving intensive care were recruited with the Glasgow Coma Scale (GCS) score. Patients in group A underwent ultrasonic ONSD to assess ICP voluntarily, whereas group B without ONSD. Patients were followed up at discharge and once a week for 3 months with Glasgow Outcome Scale (GOS) score (four to five scores indicated good prognosis and one to three scores indicated poor prognosis).Results: Forty-nine patients were included. GCS scores did not differ significantly between groups A (26 patients) and B (8 ± 3 vs. 7 ± 3, p < 0.05). In group A, ONSD was 5.01 ± 0.48 mm, which correlated with GCS score (p < 0.05). At discharge, the GOS score was higher in group A than in group B (3.35 ± 1.35 vs. 2.57 ± 1.121, p = 0.034). The proportion of patients with a good prognosis was higher in group A than in group B (46.2% vs. 13.0%, p = 0.006). At discharge and after 3 months of follow-up, ONSD at admission was correlated with the GOS score in group A (r = -0.648 [p < 0.05] and -0.731 [p < 0.05], respectively). After 3 months of follow-up, the GOS score was higher in group A than group B (3.00 ± 1.673 vs. 2.04 ± 1.430, p < 0.05). The proportion of patients with a good prognosis was higher in group A than in group B (46.2% vs. 21.2%, p = 0.039). The Kaplan-Meier curve showed a higher rate of good prognosis in group A than in group B. ONSD (p < 0.05) was an independent predictor of poor prognosis.Conclusion: Non-invasive ultrasonic ONSD could be useful in improving the prognosis of patients with AIS receiving intensive care.

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Acute kidney injury in patients with malignant middle cerebral artery infarction undergoing hyperosmolar therapy with mannitol

Cited by 7 publications

References 27 publications

Systemic immune-inflammation index may predict the acute kidney injury and prognosis in patients with spontaneous cerebral hemorrhage undergoing craniotomy: a single-center retrospective study

Systemic immune-inflammation index may predict the acute kidney injury and prognosis in patients with spontaneous cerebral hemorrhage undergoing craniotomy: a single-center retrospective study

Potentially Detrimental Effects of Hyperosmolality in Patients Treated for Traumatic Brain Injury

Ultrasonic optic nerve sheath diameter could improve the prognosis of acute ischemic stroke in the intensive care unit

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