Risk factors of early renal injury in patients with hypertensive intracerebral hemorrhage
Objective To explore the risk factors of early acute renal injury(AKI)in patients with hypertensive intracerebral hemorrhage(HICH).Methods Ninety HICH patients admitted to the Hai'an People's Hospital from July 2020 to June 2022 were enrolled.Based on the diagnostic criteria of the Kidney Disease Prognosis Quality Initiative Guidelines,the patients were divided into AKI group(n=21)and non-AKI group(n=69).Univariate and multivariate logistic regression analyses were used to evaluate whether urinary neutrophil gelatinase-associated lipocalin(NGAL),urinary microalbumin creatinine ratio(ACR),and serum homocysteine(Hcy)were independent risk factors affecting the early onset of AKI in HICH patients.The predictive value of urinary NGAL,urinary ACR,and serum Hcy for the early onset of AKI in HICH patients were evaluated by the receiver operating characteristic(ROC)curves.Results The proportions of blood transfusion or mannitol use,urinary NGAL,urinary ACR and serum Hcy in the AKI group were significantly higher than those in the non-AKI group(P<0.05).Multivariate logistic regression analysis showed that blood transfusion or mannitol use(OR=3.556,95% CI:1.608-7.864),urinary NGAL(OR=1.005,95% CI:1.002-1.008),urinary ACR(OR=1.812,95% CI:1.251-2.625),and serum Hcy(OR=1.923,95% CI:1.455-2.542)were independent risk factors for early onset of AKI in patients with HICH(P<0.05).ROC curve analysis showed that the areas under the curves of urinary NGAL,urinary ACR,and serum Hcy for the prediction of early onset of AKI in patients with HICH were 0.786(95% CI:0.680-0.892),0.676(95% CI:0.553-0.799),and 0.737(95% CI:0.631-0.843),respectively;the area under the curve of the 3 indicators was 0.914(95% CI:0.823-1.000).Conclusion Urinary NGAL,urinary ACR,and serum Hcy are independent risk factors for the onset of early AKI in patients with HICH.Each factor has certain predictive value for the onset of early AKI,and the combination of the 3 factors has higher value in predicting the onset of early AKI.
NETL
NSTL
万方数据
维普
