Authors: Nistrup Holmegaard, S.¹; Christoffersen, H.²; Haase, J.³

Source: Scandinavian Journal of Clinical and Laboratory Investigation, Volume 66, Number 5, August 2006 , pp. 437-450(14)

Publisher: Informa Healthcare

Abstract:

Objective. To investigate whether different types of stroke influence renal excretion of albumin, major electrolytes and water. Material and methods. Timed urine collections were started shortly after admission in 5 patients with haemorrhagic stroke (group A), 5 with ischaemic stroke (group Bx), 6 with presumed ischaemic stroke (groups By/z) and 6 with subarachnoid haemorrhage (group C). Albuminuria was also investigated in four patients undergoing elective abdominal surgery. Results. Increased levels of albuminuria were observed in all patients in groups A and B, but were found to decline with observation time and appeared to be related to outcome in group B. In group C, albuminuria was detected in 4 out of 6 patients. Elective surgery did not affect albumin excretion. In a setting with high urinary osmolality, high excretion rates for creatinine, urea, sodium, potassium and large diuresis were intermittently observed in groups A, B and C. None of these patients was in steady‐state condition. Conclusions. Different types of stroke elicit a complex change in renal function which resembles the response to a hypervolaemic and hyperosmolar signal, possibly mediated by a breakdown of renal autoregulation of blood flow in the presence of high vasopressin activity. Acute changes in excretion of albumin might be an indicator of prognosis in stroke. The findings point to the existence of unrecognized pathways between the central nervous system and the kidneys. Further studies on the mechanisms underlying alterations in renal function in stroke and their implication for treatment and outcome are indicated.

Keywords: Creatinine clearance; diuresis; kaliuresis; natriuresis; timed urine collections; urinary albumin excretion rate

Document Type: Research article

DOI: http://dx.doi.org/10.1080/00365510600836669

Affiliations: 1: Department of Medicine, Hospital Nord/Thisted, Denmark 2: Department of Orthopaedic Surgery, Hospital Nord/Thisted, Denmark 3: Department of Neurosurgery, Aalborg University Hospital, Denmark

Publication date: 2006-08-01

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