Associations of base excess and alactic base excess with KDIGO stage 2 – 3 acute kidney injury in patients with acute ischemic stroke

PURPOSE: To identify the associations of base excess (BE) and alactic base excess (aBE) with KDIGO stage 2 - 3 acute kidney injury (AKI) in patients with acute ischemic stroke (AIS). MATERIALS AND METHODS: In this cohort study, 1,377 adult patients with AIS were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. A univariable logistic regression model was used to explore the associations of all variables with KDIGO stage 2 - 3 AKI during the ICU stay of patients. Confounding factors were screened using bidirectional stepwise regression. Subgroup analysis was stratified based on age, Glasgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA), and comorbidities. Forest plot was plotted to identify the associations of BE and aBE with KDIGO stage 2 - 3 AKI in AIS patients in different subgroups. Restricted cubic spline (RCS) was plotted. RESULTS: A total of 1,377 participants were included, of whom 680 developed KDIGO stage 2 - 3 AKI during their ICU stay. After adjusting for covariates including SOFA, sodium, anticoagulants, furosemide, and aspirin, we found that the association between BE < -5.124 mmol/L and KDIGO stage 2 - 3 AKI was significant (OR = 1.51, 95% CI: 1.05 - 2.16). As for aBE, we observed that aBE < -3.444 mmol/L might be related to KDIGO stage 2 - 3 AKI (OR = 1.57, 95% CI: 1.12 - 2.20). In the adjusted model, aBE < -3.444 mmol/L was associated with elevated OR of KDIGO stage 2 - 3 AKI in AIS patients (OR = 1.43, 95% CI: 1.00 - 2.04). RCS revealed the non-liner associations of BE and aBE with KDIGO stage 2 - 3 AKI in AIS patients. CONCLUSION: Low BE or aBE were associated with an increased risk of KDIGO stage 2 - 3 AKI in patients with AIS.