Reflex Plasma Renin Activity, Plasminogen Activator Inhibitor and Glomerular Filtration Rate in Patients with Ischemic Cerebral Stroke

[摘要] Background: Short-term evolution following ischemic stroke can associate acute renal insufficiency as a possible complication which is frequently overlooked and underestimated. Objective: We aimed in this prospective study to estimate this incidence and to test the probable affection of plasma renin reflex sensitivity (PRRS). Methods: Twenty one consecutive cerebral ischemic patients hospitalized with a C.T. confirmed diagnosis of ischemic stroke. Seventeen control normal persons were used for comparison. Recumbent, standing plasma renin activities (PRA), PRRS, plasminogen activator inhibitor and creatinine clearance (Ccr) were estimated at admission of the patients and two weeks later. Results: The Ccr was 68±8.6 & 66±6.4 ml/min. at admission and two weeks later respectively. It was significantly lower than that of control group (103±4.0 ml/min.). PRRS had decreased significantly at admission in comparison to control persons (1.24±0.15 and 2.30±0.26 ng/ml respectively), but it had increased significantly 2 weeks later in comparison to either that at admission or of control persons (4.86 ng/ml). The decreased Ccr at admission was significantly and negatively correlated with the decrease in the sensitivity of the reflex PRA. Conclusion: Acute ischemic stroke patients had a reduced Ccr at admission and 2 weeks later, the sensitivity of reflex PRA had changed significantly from a significant decrease at admission to a significant increase 2 weeks later. This finding may be suggested as a sensitive visceral neurovegetative parameter for further studies to be added to the currently used somatosensory parameters of NIHSS (national Institute of Health Stroke Scale) for follow up of ischemic stroke accidents. (Egypt J Neurol Psychiat Neurosurg.  2010; 47(2): 297-302)

[学科分类] 精神健康和精神病学