Relationship between estimated glomerular filtration rate and severity of intracerebral hemorrhage

This is a preview and has not been published.

Relationship between estimated glomerular filtration rate and severity of intracerebral hemorrhage

Authors

Keywords:

Stroke, Intracerebral Hemorrhage, Chronic Kidney Disease, National Institutes of Health Stroke Scale, Estimated Glomerular Filtration Rate

Abstract

Background and aim: The effect of estimated glomerular filtration rate (eGFR) on intracerebral hemorrhage (ICH) severity is rarely studied. Meanwhile, the National Institute of Health Stroke Scale (NIHSS) is the gold standard scale for assessing stroke severity. Therefore, this study aimed to determine the relationship between eGFR and ICH severity.

Methods: A cross-sectional study was conducted at Dr. Wahidin Sudirohusodo General Hospital. eGFR values were divided into 4 levels namely severe, moderate, mild, and normal, while the severity of stroke based on NIHSS was mild (<5), moderate (6–14), and severe (>15). Analysis to compare eGFR group values with NIHSS used chi-square analysis, and a p-value <0.05 was considered significant.

Results: The results showed that the participants were mostly aged 45-70 years and male. Bleeding mostly occurred in the upper part of the brain (supratentorial) by 89.1%. The mean eGFR of participants was 84.65 mL/min/1.73 m² and the severity based on the NIHSS score ranged from 2-28. Furthermore, there was a significant relationship between eGFR values and NIHSS scores (p<0.001). Decreased eGFR tended to be associated with higher NIHSS indicated by a p-value of 0.018.

Conclusions: Based on the results of this study, eGFR has a relationship with the severity of ICH.

Author Biographies

Rani Kerinciani, Universitas Hasanuddin

Department of Neurology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia

Muhammad Akbar, Universitas Hasanuddin

Department of Neurology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia

Andi Weri Sompa, Universitas Muhammadiyah

Department of Neurology, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah, Makassar, Indonesia

Muhammad Nasrum Massi, Universitas Hasanuddin

Department of Clinical Microbiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia

Ashari Bahar, Universitas Hasanuddin

Department of Neurology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia

Andi Kurnia Bintang, Universitas Hasanuddin

Department of Neurology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia

References

Unnithan AKA, Das JM, Mehta P. Hemorrhagic Stroke. In: StatPearls. StatPearls Publishing; 2024. Accessed July 6, 2024. http://www.ncbi.nlm.nih.gov/books/NBK559173/

Magid-Bernstein J, Girard R, Polster S, et al. Cerebral Hemorrhage: Pathophysiology, Treatment, and Future Directions. Circ Res. 2022;130(8):1204-1229. doi:10.1161/CIRCRESAHA.121.319949

Ghoshal S, Freedman BI. Mechanisms of Stroke in Patients with Chronic Kidney Disease. Am J Nephrol. 2019;50(4):229-239. doi:10.1159/000502446

Runtuwene IM, Akbar M, Bintang AK, Tammasse J, Muis A, Zainuddin AA. Effectivity of Repetitive Transcranial Magnetic Stimulation Improving Depressive Symptoms and Motoric Strength Ischemic Stroke. Nusant Med Sci J. 8(1):25-37.

Verawaty A, Islam AA, Ihwan A, et al. Relationship of Serum S-100B Protein and Prognosis of Traumatic Brain Injury Patients: A cross-sectional study. Indones Surg J. 2(1):26-30.

Prasetyo E. The primary, secondary, and tertiary brain injury. Crit Care Shock. 2020;23:4-13.

Xu Y, Chen A, Wu J, et al. Nanomedicine: An Emerging Novel Therapeutic Strategy for Hemorrhagic Stroke. Int J Nanomedicine. 2022;Volume 17:1927-1950. doi:10.2147/IJN.S357598

Kurniawan VR, Islam AA, Adhimarta W, et al. The role of diphenhydramine HCl on tumor necrosis factor-α levels in wistar rats with traumatic brain injury: An in vivo study. Ann Med Surg 2012. 2022;81:104399. doi:10.1016/j.amsu.2022.104399

Jain S, Iverson LM. Glasgow Coma Scale. In: StatPearls. StatPearls Publishing; 2024. Accessed November 16, 2024. http://www.ncbi.nlm.nih.gov/books/NBK513298/

Lyden P. Using the National Institutes of Health Stroke Scale: A Cautionary Tale. Stroke. 2017;48(2):513-519. doi:10.1161/STROKEAHA.116.015434

Mahdy ME, Ghonimi NA, Elserafy TS, Mahmoud W. The NIHSS score can predict the outcome of patients with primary intracerebral hemorrhage. Egypt J Neurol Psychiatry Neurosurg. 2019;55(1):21. doi:10.1186/s41983-019-0056-0

Cusumano AM, Tzanno-Martins C, Rosa-Diez GJ. The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool. Front Med. 2021;8. doi:10.3389/fmed.2021.769335

Li Z, Li Z, Zhou Q, Gu H, Wang Y, Zhao X. Effects of estimated glomerular filtration rate on clinical outcomes in patients with intracerebral hemorrhage. BMC Neurol. 2022;22:19. doi:10.1186/s12883-022-02551-2

You S, Shi L, Zhong C, et al. Prognostic Significance of Estimated Glomerular Filtration Rate and Cystatin C in Patients with Acute Intracerebral Hemorrhage. Cerebrovasc Dis. 2016;42(5-6):455-463. doi:10.1159/000448340

Kai S, Jiaoyan Q, Weihua S, et al. Low Estimated Glomerular Filtration Rate is Associated with High Recurrence Rate and Poor Prognosis of Hemorrhage Stroke. Curr Neurovasc Res. 2015;12(2):109-119. doi:10.2174/1567202612666150305110709

Feigin VL, Abate MD, Abate YH, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol. 2024;23(10):973-1003. doi:10.1016/S1474-4422(24)00369-7

Soto-Cámara R, González-Bernal JJ, González-Santos J, Aguilar-Parra JM, Trigueros R, López-Liria R. Knowledge on Signs and Risk Factors in Stroke Patients. J Clin Med. 2020;9(8):2557. doi:10.3390/jcm9082557

Sun T, Yuan Y, Wu K, Zhou Y, You C, Guan J. Trends and patterns in the global burden of intracerebral hemorrhage: a comprehensive analysis from 1990 to 2019. Front Neurol. 2023;14. doi:10.3389/fneur.2023.1241158

Azzahra V, Ronoatmodjo S. Faktor-faktor yang Berhubungan dengan Kejadian Stroke pada Penduduk Usia ≥15 Tahun di Provinsi Daerah Istimewa Yogyakarta (Analisis Data Riskesdas 2018). J Epidemiol Kesehat Indones. 2023;6. doi:10.7454/epidkes.v6i2.6508

Wang IK, Yen TH, Tsai CH, et al. Renal function is associated with one-month and one-year mortality in patients with intracerebral hemorrhage. PLOS ONE. 2023;18(1):e0269096. doi:10.1371/journal.pone.0269096

Jolink WMT, Wiegertjes K, Rinkel GJE, Algra A, De Leeuw FE, Klijn CJM. Location-specific risk factors for intracerebral hemorrhage: Systematic review and meta-analysis. Neurology. 2020;95(13). doi:10.1212/WNL.0000000000010418

Rajashekar D, Liang JW. Intracerebral Hemorrhage. In: StatPearls. StatPearls Publishing; 2024. Accessed November 7, 2024. http://www.ncbi.nlm.nih.gov/books/NBK553103/

Lioutas VA, Beiser AS, Aparicio HJ, et al. Assessment of Incidence and Risk Factors of Intracerebral Hemorrhage Among Participants in the Framingham Heart Study Between 1948 and 2016. JAMA Neurol. 2020;77(10):1252-1260. doi:10.1001/jamaneurol.2020.1512

Mayerhofer E, Zaba NO, Parodi L, et al. Disparities in brain health comorbidity management in intracerebral hemorrhage. Front Neurol. 2023;14. doi:10.3389/fneur.2023.1194810

Cho S, Rehni AK, Dave KR. Tobacco Use: A Major Risk Factor of Intracerebral Hemorrhage. J Stroke. 2021;23(1):37-50. doi:10.5853/jos.2020.04770

Wilting FN, Sondag L, Schreuder FH, et al. Surgery for spontaneous supratentorial intracerebral haemorrhage - Wilting, FNH - 2022 | Cochrane Library. Accessed November 8, 2024. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015387/full

Amer HA, El-Jaafary SIM, Sadek HMAEA, Fouad AM, Mohammed SS. Clinical and paraclinical predictors of early neurological deterioration and poor outcome in spontaneous intracerebral hemorrhage. Egypt J Neurol Psychiatry Neurosurg. 2023;59(1):74. doi:10.1186/s41983-023-00675-x

Fukuda-Doi M, Yamamoto H, Koga M, et al. Impact of Renal Impairment on Intensive Blood-Pressure–Lowering Therapy and Outcomes in Intracerebral Hemorrhage. Neurology. 2021;97(9):e913-e921. doi:10.1212/WNL.0000000000012442

Shemilt R, Sullivan MK, Hanlon P, et al. Sex differences in cancer outcomes across the range of eGFR. Nephrol Dial Transplant. 2024;39(11):1799-1808. doi:10.1093/ndt/gfae059

Chakraborty D. Intracerebral Hemorrhage in Renal Compromised State: How is the Combination? Ann Indian Acad Neurol. 2023;26(4):374-375. doi:10.4103/aian.aian_612_23

Zhu J, Shen X, Han C, et al. Renal Dysfunction Associated with Symptomatic Intracranial Hemorrhage after Intravenous Thrombolysis. J Stroke Cerebrovasc Dis. 2019;28(11):104363. doi:10.1016/j.jstrokecerebrovasdis.2019.104363

Casolla B, Moulin S, Kyheng M, et al. Five-Year Risk of Major Ischemic and Hemorrhagic Events After Intracerebral Hemorrhage. Stroke. 2019;50(5):1100-1107. doi:10.1161/STROKEAHA.118.024449

An L, Yu Q, Chen L, et al. The Association Between the Decline of eGFR and a Reduction of Hemoglobin A1c in Type 2 Diabetic Patients. Front Endocrinol. 2022;12:723720. doi:10.3389/fendo.2021.723720

How to Cite

1.
Kerinciani R, Akbar M, Sompa AW, Massi MN, Bahar A, Bintang AK. Relationship between estimated glomerular filtration rate and severity of intracerebral hemorrhage. Acta Biomed. 95(6):e2024186. doi:10.23750/abm.v95i6.16614

Issue

Section

ORIGINAL CLINICAL RESEARCH

How to Cite

1.
Kerinciani R, Akbar M, Sompa AW, Massi MN, Bahar A, Bintang AK. Relationship between estimated glomerular filtration rate and severity of intracerebral hemorrhage. Acta Biomed. 95(6):e2024186. doi:10.23750/abm.v95i6.16614