The Association Between Aneurysmal Subarachnoid Haemorrhage and Biomarkers for Renal Dysfunction at the Time of Admission

Abstract

INTRODUCTION Rupture of a cerebral artery aneurysm is an event associated with intracranial and extracranial complications. Disturbance of renal function is said to be an extracranial complication but there is little information regarding incidence and time course of this problem. Changes in renal function may be assessed in several ways including change in serum creatinine levels over time. AIM The purpose of this study was to determine whether evidence of a risk of developing acute renal failure exists during the first 48 hours of hospitalisation in patients with aneurysmal subarachnoid haemorrhage (aSAH). METHODS Change in serum creatinine levels measured on admission and at 48 hours after admission in patients with documented aSAH was calculated. Patients were divided into two subgroups. Those in whom serum creatinine increased by more than 26.5 micromoles/litre (μmol/L) over 48hours were placed in Subgroup A. Those patients who did not demonstrate an increase of that magnitude were placed in Subgroup B. RESULTS Of the 23 patients who entered the study, 21 did not demonstrate a rise in serum creatinine of more than 26.5 μmol/L over 48 hours. Only 2 of 23 patients demonstrated such a change in serum creatinine. The proportion 21 of 23 patients is statistically significant (p <0.001). Serum creatinine levels, presented as mean ± 1 standard deviation (SD) was 63.0 ± 9.9 μmol/L and 65.8 ± 24.1 μmol/L, for Subgroups A and B, respectively. The difference is not significant. At 48 hours, the serum creatinine levels were 183.0 ± vii 36.8 μmol/L and 56.6 ± 17.0 μmol/, for Subgroups A and B, respectively. The difference is statistically significant (p<0.05). For Subgroup B, the difference in serum creatinine on admission and at 48hours post admission was not statistically different. CONCLUSION Within the first 48hours of hospital admission 91.4% of patients with aSAH did not exhibit a rise in serum creatinine of such magnitude that they could be considered as at risk for developing acute renal failure.