Association of anion gap and albumin corrected anion gap with acute kidney injury in patients with acute ischemic stroke.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Clinical and Experimental Medicine Pub Date : 2024-06-11 DOI:10.17219/acem/186814

Haiqian Yao, Jianan Tian, Shi Cheng

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引用次数: 0

Abstract

Background: Acute kidney injury (AKI) has become a common complication of acute ischemic stroke (AIS) and may have a significant impact on clinical outcomes. Anion gap (AG)/albumin corrected anion gap (ACAG) are used to assess acid-base balance status and help identify the severity of metabolic acidosis.

Objectives: To explore the association of AG and ACAG with the risk of AKI in AIS patients admitted to the intensive care unit (ICU).

Material and methods: Data of AIS patients in this retrospective cohort study were extracted from the electronic ICU (eICU) databases (2014-2015). The outcome was the occurrence of AKI after ICU admission. The covariates included demographic data, vital signs, comorbidities, laboratory parameters, and medication use. The association of AG and ACAG levels with AKI risk in AIS patients was evaluated using univariate and multivariate logistic regression models with odds ratios (ORs) and 95% confidence intervals (95% CIs). The predictive performance of AG and ACAG for the risk of AKI in AIS patients was assessed with the area under the curve (AUC). To further explore the association of AG and ACAG levels with AKI risk, subgroup analyses were performed according to comorbidities.

Results: Of the 1,260 AIS patients, 546 (43%) developed AKI. Elevated AG (OR = 1.73, 95% CI: 1.32-2.29) and ACAG (OR = 1.57, 95% CI: 1.21-2.04) were associated with the risk of AKI in AIS patients. The AUC of ACAG was superior to AG for predicting the risk of AKI (0.581 vs 0.558; p = 0.024). Elevated ACAG levels were associated with the risk of AKI in AIS patients without ischemic heart disease (OR = 1.60, 95% CI: 1.19-2.15), diabetes (OR = 1.58, 95% CI: 1.19-2.10) and hypertension (OR = 1.69, 95% CI: 1.24-2.30).

Conclusions: Albumin corrected anion gap was a better predictor than AG for AKI risk in AIS patients, which may help clinicians identify high-risk patients for AKI.

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急性缺血性脑卒中患者的阴离子间隙和白蛋白校正阴离子间隙与急性肾损伤的关系。

背景：急性肾损伤（AKI）已成为急性缺血性卒中（AIS）的常见并发症，可能对临床预后产生重大影响。阴离子间隙（AG）/白蛋白校正阴离子间隙（ACAG）用于评估酸碱平衡状态，有助于确定代谢性酸中毒的严重程度：探讨AG和ACAG与重症监护室（ICU）收治的AIS患者发生AKI风险的关系：这项回顾性队列研究中的AIS患者数据来自重症监护室（eICU）电子数据库（2014-2015年）。研究结果为入院后发生 AKI。协变量包括人口统计学数据、生命体征、合并症、实验室参数和用药情况。采用单变量和多变量逻辑回归模型评估了AIS患者AG和ACAG水平与AKI风险的关系，并得出了几率比（OR）和95%置信区间（95% CI）。用曲线下面积（AUC）评估了AG和ACAG对AIS患者AKI风险的预测性能。为进一步探讨AG和ACAG水平与AKI风险的关系，根据合并症进行了亚组分析：在 1260 名 AIS 患者中，有 546 人（43%）发生了 AKI。AG（OR = 1.73，95% CI：1.32-2.29）和 ACAG（OR = 1.57，95% CI：1.21-2.04）升高与 AIS 患者发生 AKI 的风险有关。在预测 AKI 风险方面，ACAG 的 AUC 值优于 AG 值（0.581 vs 0.558; p = 0.024）。在无缺血性心脏病（OR = 1.60，95% CI：1.19-2.15）、糖尿病（OR = 1.58，95% CI：1.19-2.10）和高血压（OR = 1.69，95% CI：1.24-2.30）的 AIS 患者中，ACAG 水平升高与 AKI 风险相关：白蛋白校正阴离子间隙比AG更能预测AIS患者发生AKI的风险，这可能有助于临床医生识别发生AKI的高危患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.