title: Acute Kidney Injury After Subarachnoid Hemorrhage.
abstract: BACKGROUND
  Acute kidney injury (AKI) is common in critically ill patients and may contribute to poor outcome. Few data are available on the incidence and impact of AKI in patients suffering from nontraumatic subarachnoid hemorrhage (SAH).
  
  
  METHODS
  We reviewed all patients admitted to our Department of Intensive Care with SAH over a 3-year period. Exclusion criteria were time from SAH symptoms to intensive care unit (ICU) admission >96 hours and ICU stay <48 hours. AKI was defined as sustained oligoanuria (urine output <0.5 mL/kg/h for 24 h) or an increase in plasma creatinine (≥0.3 mg/dL or a 1.5-fold increase from baseline level within 48 h). Neurological status was assessed at day 28 using the Glasgow Outcome Scale (GOS) (from 1=death to 5=good recovery; favorable outcome=GOS 4 to 5).
  
  
  RESULTS
  Of 243 patients admitted for SAH during the study period, 202 met the inclusion/exclusion criteria (median age 56 y, 78 male). Twenty-five patients (12%) developed AKI, a median of 8 (4 to 10) days after admission. Independent predictors of AKI were development of clinical vasospasm, and treatment with vancomycin. AKI was more frequent in ICU nonsurvivors than in survivors (11/50 vs. 14/152, P=0.03), and in patients with an unfavorable neurological outcome than in other patients (17/93 vs. 8/109, P=0.03). Nevertheless, in multivariable regression analysis, AKI was not an independent predictor of outcome.
  
  
  CONCLUSIONS
  AKI occurred in >10% of patients after SAH. These patients had more severe neurological impairment and needed more aggressive ICU therapy; AKI did not significantly influence outcome.
authors.affiliation: Departments of *Intensive Care †Nephrology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Omar
authors.initials: O
authors.lastname: Tujjar
authors.forename: Ilaria
authors.initials: I
authors.lastname: Belloni
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hougardy
authors.forename: Sabino
authors.initials: S
authors.lastname: Scolletta
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Jacques
authors.initials: J
authors.lastname: Creteur
authors.forename: Fabio S
authors.initials: FS
authors.lastname: Taccone
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology*; D001530:Belgium / Q000453:epidemiology; D015897:Comorbidity; D016638:Critical Illness; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*