The impact of acute kidney injury on in-hospital mortality in acute ischemic stroke patients undergoing intravenous thrombolysis

Gădălean, Florica; Simu, Mihaela; Pârv, Florina; Vorovenci, Ruxandra Julia; Tudor, Raluca; Schiller, Adalbert; Timar, Romulus; Petrică, Ligia; Velciov, Silvia; Gluhovschi, Cristina; Bob, Flaviu; Mihaescu, Adelina; Timar, Bogdan; Spasovski, Goce; Ivan, Viviana

doi:10.1371/journal.pone.0185589

Cited by 31 publications

(26 citation statements)

References 34 publications

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“…It's important to understand that there is much more to an echo exam than mere EF [5]. eGFR value alone-demonstrated that is a better follow-up parameter then EF, as a marker for cardiovascular morbidity and mortality [21].So, in this special population we have to come with something more in orderto add more prognostic value. The novel tissue Doppler and Speckle tracking techniques can guide us to understand and treat the complex patient involved in this pathophysiological relation between kidney and heart [8][9][10][11][12].Also, in most studies, arterial stiffness is assessed by carotid-femural pulse wave velocity (cfPWV), andwould have been a useful markerbecause it is correlated with overall mortality and cardiovascular mortality,even in dialysis patients [22].…”

Section: Resultsmentioning

confidence: 99%

Furosemide Pharmacodynamics and Cardiovascular Effects in Hemodialysis Patients

Albulescu¹,

Apostol²,

Albulescu³

et al. 2019

Rev. Chim.

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Furosemide is a drug that has not only a renal effect, but also a vascular one, resulting in decreased left atrial and ventricularfilling pressure accompanied by an increase in venous compliance, all of this with significant effects on central cardiac hemodynamics.In dialysis patients, it is still unclear the efficiency of furosemide, a diuretic drug that inhibits the Na+, K+, 2CL� cotransporter in the renal tubular system. Also, furosemide need to be used at much higher doses because of its pharmacokinetic changes in the context of impaired renal clearance.The aim of our study was to investigate whether furosemide induces changes in cardiovascular hemodynamics in end-stage renal disease (ESRD) patients, using standard echocardiography and Tissue Doppler Imaging (TDI).We foundcorrelations between furosemide useand improved cardiac parameters, assessed by multiple echocardiographic variables, and we consider that furosemide has complementary effects in dialysis patients with residual diuresis.

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Section: Resultsmentioning

confidence: 99%

Furosemide Pharmacodynamics and Cardiovascular Effects in Hemodialysis Patients

Albulescu¹,

Apostol²,

Albulescu³

et al. 2019

Rev. Chim.

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“…Also, among patients with acute haemorrhagic stroke, AKI contributed to 83.33% of mortality. In a study done by Florica Gadalean ET al 14 on 45 patients with stroke with median follow up of 12 days, 50% of patients who developed AKI expired and among subjects who did not develop AKI only 3.44% expired.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury in Acute Stroke in Relation to Immediate Outcome- A Hospital Based Study

Bhattacharjee¹,

Paul²,

Roy³

et al. 2020

jebmh

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BACKGROUND Acute stroke is the second leading cause of death. The association of renal function and stroke is poorly understood. The present study is focused at assessing renal functional status in acute stroke and its prognostic significance on final outcome. METHODS Patients presenting with acute stroke numbering 200 were included for study duration of 1 year. Serum creatinine and 24-hour urine output were monitored after admission, at 24 and 48 hours and were evaluated during the in hospital stay. AKI has been defined according to KDIGO criteria. RESULTS The mean age of study population was 60±8.5 years. The overall incidence of AKI in stroke was 17% and commoner in subjects with haemorrhagic stroke. Patients with AKI had longer hospital stay and were associated with higher risk of mortality as compared to those who did not develop AKI. CONCLUSIONS Incidence of AKI complicating acute stroke is associated with increased mortality and adverse outcome. This highlights the need for early diagnosis, better risk stratification and preparedness for need for long-term care in this vulnerable population.

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“…Also, transthoracic echocardiography (TTE), ECG Holter monitoring and serial blood samples were analysed. Baseline renal function was assessed using the CKD-EPI creatinine equation [9]. The panel of biomarkers availabled for monitoring and for the prognosis of acute kidney injury(AKI) were limited at that time and nowadays numerous studies have proven the importance of microRNAs in this field [10,11].…”

Section: Experimental Part Materials and Methodsmentioning

confidence: 99%

Cardiac Electrical Vulnerability after Acute Myocardial Infarction Associated with Respiratory Infections

Albulescu¹,

Ivan²,

Apostol³

et al. 2019

Rev. Chim.

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Heart rate variability and the presence of late potentials are independent predictor factors for cardiac death and electrical vulnerability of the ischemic myocardium, especially after myocardial infarction(MI). Respiratory infection are known to be associated with MI both through direct action of the pathogen and by altering the hemodynamic status, through tachycardia and a rise in myocardial oxigen demand. Our paper wants to highlight that respiratory infection during subacute and late recovery phase of myocardial infarction can aggravate the electrical vulnerability of the myocardium and increases the arrhythmic risk. We analysed heart rate variability and the presence of late potentials on signal-averaged ECG in patients who developed acute respiratory infection after MI. All parameters of heart rate variability were signifficantly decreased in our target group. Incidence of late potentials did not differ between the two groups, meaning that the electrophysiological substrate of arrhythmias was not influenced by respiratory infection. Ventricular arrhythmias were more severe and frequent in the infection group. Respiratory infectious disease in early and late recovery phase after acute myocardial infarction, increases the risk of life threatening arrhythmias. It must be emphasized the need to consider prevention and early treatment of respiratory viral or bacterial infections, particularly in patients with cardiac ischemic disease.

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The impact of acute kidney injury on in-hospital mortality in acute ischemic stroke patients undergoing intravenous thrombolysis

Abstract: Introduction

Cited by 31 publications

References 34 publications

Furosemide Pharmacodynamics and Cardiovascular Effects in Hemodialysis Patients

Furosemide Pharmacodynamics and Cardiovascular Effects in Hemodialysis Patients

Acute Kidney Injury in Acute Stroke in Relation to Immediate Outcome- A Hospital Based Study

Cardiac Electrical Vulnerability after Acute Myocardial Infarction Associated with Respiratory Infections

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