PMID- 32838673
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1524-4628 (Electronic)
IS  - 0039-2499 (Linking)
VI  - 51
IP  - 10
DP  - 2020 Oct
TI  - Systolic Blood Pressure Reduction and Acute Kidney Injury in Intracerebral 
      Hemorrhage.
PG  - 3030-3038
LID - 10.1161/STROKEAHA.120.030272 [doi]
AB  - BACKGROUND AND PURPOSE: We determined the rates and predictors of acute kidney 
      injury (AKI) and renal adverse events (AEs), and effects of AKI and renal AEs on 
      death or disability in patients with intracerebral hemorrhage. METHODS: We 
      analyzed data from a multicenter trial which randomized 1000 intracerebral 
      hemorrhage patients with initial systolic blood pressure >/=180 mm Hg to intensive 
      (goal 110-139 mm Hg) over standard (goal 140-179 mm Hg) systolic blood pressure 
      reduction within 4.5 hours of symptom onset. AKI was identified by serial 
      assessment of daily serum creatinine for 3 days post randomization. RESULTS: AKI 
      and renal AEs were observed in 149 patients (14.9%) and 65 patients (6.5%) among 
      1000 patients, respectively. In multivariate analysis, the higher baseline serum 
      creatinine (>/=110 mumol/L) was associated with AKI (odds ratio 2.4 [95% CI, 
      1.2-4.5]) and renal AEs (odds ratio 3.1 [95% CI, 1.2-8.1]). Higher area under the 
      curve for intravenous nicardipine dose was associated with AKI (odds ratio 1.003 
      [95% CI, 1.001-1.005]) and renal AEs (odds ratio 1.003 [95% CI, 1.001-1.006]). 
      There was a higher risk to death (relative risk 2.6 [95% CI, 1.6-4.2]) and death 
      or disability (relative risk 1.5 [95% CI, 1.3-1.8]) at 90 days in patients with 
      AKI but not in those with renal AEs. CONCLUSIONS: Intracerebral hemorrhage 
      patients with higher baseline serum creatinine and those receiving higher doses 
      of nicardipine were at higher risk for AKI and renal AEs. Occurrence of AKI was 
      associated higher rates of death or disability at 3 months. Registration: URL: 
      https://clinicaltrials.gov. Unique identifier: NCT01176565.
FAU - Qureshi, Adnan I
AU  - Qureshi AI
AD  - Zeenat Qureshi Stroke Institute, and Department of Neurology, University of 
      Missouri-Columbia (A.I.Q., W.H., I.L.).
FAU - Huang, Wei
AU  - Huang W
AD  - Zeenat Qureshi Stroke Institute, and Department of Neurology, University of 
      Missouri-Columbia (A.I.Q., W.H., I.L.).
FAU - Lobanova, Iryna
AU  - Lobanova I
AD  - Zeenat Qureshi Stroke Institute, and Department of Neurology, University of 
      Missouri-Columbia (A.I.Q., W.H., I.L.).
FAU - Hanley, Daniel F
AU  - Hanley DF
AD  - The Neurology Department of Johns Hopkins University, Baltimore, MD (D.F.H.).
FAU - Hsu, Chung Y
AU  - Hsu CY
AD  - Graduate Institute of Clinical Medical Science, China Medical University, 
      Taichung, Taiwan (C.Y.H.).
FAU - Malhotra, Kunal
AU  - Malhotra K
AD  - Department of Nephrology, University of Missouri-Columbia. (K.M.).
FAU - Steiner, Thorsten
AU  - Steiner T
AD  - Department of Neurology, Klinikum Frankfurt Hochst, Germany (T.S.).
AD  - Department of Neurology, Heidelberg University Hospital, Germany (T.S.).
FAU - Suarez, Jose I
AU  - Suarez JI
AD  - Division of Neurosciences Critical Care, The Johns Hopkins University School of 
      Medicine, Baltimore, MD (J.I.S.).
FAU - Toyoda, Kazunori
AU  - Toyoda K
AD  - Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular 
      Center, Suita, Japan. (K.T.).
FAU - Yamamoto, Haruko
AU  - Yamamoto H
AD  - Center for Advancing Clinical and Translational Sciences, National Cerebral and 
      Cardiovascular Center, Suita, Japan. (H.Y.).
CN  - Antihypertensive Treatment of Cerebral Hemorrhage 2 Trial Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01176565
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200825
PL  - United States
TA  - Stroke
JT  - Stroke
JID - 0235266
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Acute Kidney Injury/blood/epidemiology/*etiology/physiopathology
MH  - Age Factors
MH  - Aged
MH  - Blood Pressure/*physiology
MH  - Cerebral Hemorrhage/blood/*complications/physiopathology
MH  - Creatinine/blood
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Sex Factors
OTO - NOTNLM
OT  - acute kidney injury
OT  - blood pressure
OT  - cerebral hemorrhage
OT  - creatinine
OT  - death
EDAT- 2020/08/26 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/08/26 06:00
PHST- 2020/08/26 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/08/26 06:00 [entrez]
AID - 10.1161/STROKEAHA.120.030272 [doi]
PST - ppublish
SO  - Stroke. 2020 Oct;51(10):3030-3038. doi: 10.1161/STROKEAHA.120.030272. Epub 2020 
      Aug 25.