Acute kidney injury in patients with malignant middle cerebral artery infarction undergoing hyperosmolar therapy with mannitol.

Published on Feb 26, 2021in Journal of Critical Care2.685
· DOI :10.1016/J.JCRC.2021.02.007
Haidar Moustafa4
Estimated H-index: 4
(TUD: Dresden University of Technology),
Daniela Schoene (TUD: Dresden University of Technology)+ 10 AuthorsKristian Barlinn21
Estimated H-index: 21
(TUD: Dresden University of Technology)
Abstract Purpose To assess the kidney safety profile of mannitol in patients with malignant middle cerebral artery (MCA) infarction. Material and methods We studied consecutive patients with malignant MCA infarction (01/2008–01/2018). Malignant MCA infarction was defined according to DESTINY criteria. We compared clinical endpoints including acute kidney injury (AKI; according to Kidney Disease: Improving Global Outcomes [KDIGO]) and dialysis between patients with and without mannitol. Multivariable model was built to explore predictor variables of AKI and in-hospital death. Results Overall, 219 patients with malignant MCA infarction were included. Mannitol was administered in 93/219 (42.5%) patients with an average dosage of 650 g (250-950 g). Patients treated with mannitol more frequently suffered from AKI (39.8% vs. 11.9%; p  Conclusions Acute kidney injury appears to be a frequent complication of hyperosmolar therapy with mannitol in patients with malignant MCA infarction. Given the lack of evidence supporting effectiveness of mannitol in these patients, its routine use should be carefully considered.
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