Relationship between urinary biomarker and the incidence of acute kidney injury after thrombolytic therapy in acute ischemic stroke patients at the stroke care unit.

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K20403
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Emergency medicine
• Research Institution: Nippon Medical School
• Principal Investigator: Shimoyama Takashi 日本医科大学, 医学部, 助教 (00509325)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 急性期脳梗塞 / 急性腎障害 / 尿中バイオマーカー / Stroke Care Unit

Outline of Final Research Achievements

In total, 527 acute ischemic stroke patients (342 males; median age 74 years) were enrolled to the study. Twenty-seven patients (5.1%) occurred AKI within 7 days after admission. In the univariate analysis, high urinary L-FABP level had positive associations with AKI (53.8 μg/g Cr vs. 3.9 μg/g Cr, P<0.001) and 90-day mortality (15.5 μg/g Cr vs. 4.0 μg/g Cr, P<0.001). In the multivariate analysis, elevated urinary L-FABP level (per 10 μg/g Cr increase) was independently associated with AKI (Odds ratio [OR] 1.225; 95% confidence interval (CI), 1.083-1.454, P=0.003) and 90-day mortality (Hazard ratio [HR] 1.091; 95% CI, 1.045-1.138, P<0.001). Urinary biomarker of kidney tubule injury is independently associated with the development of AKI and 90-day mortality in acute ischemic stroke patients treated at the SCU.

Free Research Field

脳神経内科　救急医学

Academic Significance and Societal Importance of the Research Achievements

今回の研究により急性期脳梗塞後に急性腎障害を発症する頻度は5.1％という事実が判明した。前向きに脳梗塞患者の急性腎障害の頻度を検討した報告はなく貴重な所見と考える。また急性腎障害のバイオマーカーである尿中L-FABP値の上昇は脳梗塞後の急性腎障害発症だけでなく3ヶ月後死亡にも関連があることを示せた。これまでに尿中バイオマーカーと急性期脳梗塞患者の転帰について検討した報告はなく非常に重要な研究成果と考える。