Increased risk of acute kidney injury associated with higher infusion rate of mannitol in patients with intracranial hemorrhage

Clinical article

Min Young Kim ,MD et al

Journal of Neurosurgery

Jun 2014 / Vol. 120 / No. 6 / Pages 1340-1348 

 The objectives of this study were to assess the impact of mannitol on the incidence and severity of acute kidney injury (AKI) and to identify risk factors and outcome for AKI in patients with intracranial hemorrhage (ICH).

 The authors retrospectively evaluated 153 adult patients who received mannitol infusion after ICH between January 2005 and December 2009 in the neurosurgical intensive care unit.

 The overall incidence of AKI among study participants was 10.5% 

(n = 16). 

Acute kidney injury occurred more frequently in patients who received mannitol infusion at a rate ≥ 1.34 g/kg/day than it did in patients who received mannitol infusion at a rate < 1.34 g/kg/day.

 A higher mannitol infusion rate was associated with more severe AKI. Independent risk factors for AKI were mannitol infusion rate ≥ 1.34 g/kg/day, age ≥ 70 years, diastolic blood pressure (DBP) ≥ 110 mm Hg, and glomerular filtration rate < 60 ml/min/1.73 m²