Association of Perioperative Hyperchloremia and Hyperchloremic Metabolic Acidosis with Acute Kidney Injury After Craniotomy for Intracranial Hemorrhage

World Neurosurgery
Tak Kyu OhSang-Hwan Do

Abstract

The present study evaluated the relationships among perioperative hyperchloremic metabolic acidosis (HCA), hyperchloremia, and postoperative acute kidney injury (AKI) in patients who had undergone craniotomy for intracranial hemorrhage (ICH). The present retrospective cohort study included adult patients who had undergone craniotomy for traumatic or spontaneous ICH from January 2005 to December 2017. The association of perioperative hyperchloremia (serum chloride [Cl-] >110 mmol/L during postoperative days 0-3), an increase in Cl- levels (maximum Cl- level in postoperative days 0-3 minus the baseline Cl- level before surgery), and perioperative HCA (Cl- >110 mmol/L; pH <7.35, with a bicarbonate level <24 mmol/L) with the incidence of AKI was analyzed using multivariable logistic regression analysis. A total of 968 patients were included. Of these patients, 117 (12.1%) had postoperative AKI. The multivariable logistic regression analysis showed that the development of HCA was associated with a 1.850-fold increase in the incidence of postoperative AKI (odds ratio [OR], 1.850; 95% confidence interval [CI], 1.102-3.106; P = 0.020). However, hyperchloremia was not significantly related to the incidence of postoperative AKI (P = 0.20...Continue Reading

Citations

May 23, 2020·The American Journal of Nursing·Lydia A Bertschi
Aug 28, 2020·Journal of Clinical Laboratory Analysis·Ruo Ran WangYan Kang
Dec 8, 2020·Journal of Intensive Care Medicine·David P YamaneDanielle Davison

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