title: Albuminuria, intermittent hyperfiltration and salt wasting in patients with stroke: a pilot study.
abstract: OBJECTIVE
  To investigate whether different types of stroke influence renal excretion of albumin, major electrolytes and water.
  
  
  METHODS
  Timed urine collections were started shortly after admission in 5 patients with haemorrhagic stroke (group A), 5 with ischaemic stroke (group Bx), 6 with presumed ischaemic stroke (groups By/z) and 6 with subarachnoid haemorrhage (group C). Albuminuria was also investigated in four patients undergoing elective abdominal surgery.
  
  
  RESULTS
  Increased levels of albuminuria were observed in all patients in groups A and B, but were found to decline with observation time and appeared to be related to outcome in group B. In group C, albuminuria was detected in 4 out of 6 patients. Elective surgery did not affect albumin excretion. In a setting with high urinary osmolality, high excretion rates for creatinine, urea, sodium, potassium and large diuresis were intermittently observed in groups A, B and C. None of these patients was in steady-state condition.
  
  
  CONCLUSIONS
  Different types of stroke elicit a complex change in renal function which resembles the response to a hypervolaemic and hyperosmolar signal, possibly mediated by a breakdown of renal autoregulation of blood flow in the presence of high vasopressin activity. Acute changes in excretion of albumin might be an indicator of prognosis in stroke. The findings point to the existence of unrecognized pathways between the central nervous system and the kidneys. Further studies on the mechanisms underlying alterations in renal function in stroke and their implication for treatment and outcome are indicated.
authors.affiliation: Department of Medicine, Hospital Nord/Thisted, Denmark. stinho@mail.dk
authors.forename: S
authors.initials: S
authors.lastname: Nistrup Holmegaard
authors.forename: H
authors.initials: H
authors.lastname: Christoffersen
authors.forename: J
authors.initials: J
authors.lastname: Haase
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000652:urine*; D005260:Female; D005374:Filtration; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012965:Sodium Chloride / Q000652:urine*; D020521:Stroke / Q000652:urine*
chemical_list: D012965:Sodium Chloride