A transient improvement in renal function occurs after ischemic stroke.
BACKGROUND
Neurohumoral effects have been suggested to affect kidney function. Stroke is a condition where regulation of the renin-angiotensin system and sympathetic nerve activity are altered.


METHODS
Renal function as estimated by serum creatinine was analyzed over 1 week in 220 patients after acute ischemic stroke.


RESULTS
In patients with chronic kidney disease defined as those with serum creatinine >1.2 mg/dL at admission (n = 62), renal function transiently improved, measured by a mean decrease of creatinine of 0.34 mg/dL during the first days after stroke. A significant and transient decrease of creatinine was also observed in patients with diabetes (n = 69) or patients with heart failure (n = 89). In both subgroups creatinine decreased by a mean of 0.49 and 0.24 mg/dL, respectively (p < 0.05 for both). In patients with normal renal function at admission, no change in serum creatinine occurred during the first week after stroke. There was no association between stroke severity and creatinine change.


CONCLUSIONS
An acute ischemic cerebrovascular event intermittently improves impaired kidney function. The underlying mechanism may involve central regulation of renal function.
Division of Nephrology and Dialysis, Department of Internal Medicine 3, Medical University of Vienna, Vienna, Austria. dominik.haider@meduniwien.ac.at
Dominik Georg
DG
Haider
Julia
J
Ferrari
Friedrich
F
Mittermayer
Michael
M
Wolzt
Walter Hermann
WH
Hörl
Wolfgang
W
Lalouschek
Wilfried
W
Lang
D000368:Aged; D002545:Brain Ischemia / Q000503:physiopathology*; D002908:Chronic Disease; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000097:blood* / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D020521:Stroke / Q000097:blood* / Q000503:physiopathology*; D013997:Time Factors
D003404:Creatinine