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Croatian Journal of Anaesthesiology and Intensive medicine, Vol. 1 No. 1, 2025.

Case report, case study

https://doi.org/10.66166/cjaim.1.1.9

Acute Kidney Injury in a Patient with Aneurysmatic Subarachnoid Haemorrhage: A Case Report

Martina Miklić Bublić orcid id orcid.org/0000-0002-4471-1117 ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia *
Dinko Tonković ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; University of Zagreb, School of Medicine, Department of Anaesthesiology, Reanimatology and Intensive Care Medicine
Alka Makovšek ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Marijana Matas ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Ivan Paripović ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Marin Mandić ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Dijana Kukin ; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, Zagreb University Hospital Centre, Zagreb, Croatia

* Corresponding author.

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Abstract

Aneurysmatic SAH (aSAH) is a life-threatening condition, with an incidence of 6–10 cases per 100,000 patients annually. It can present with an intense headache described as "the worst headache of your life", nausea and vomiting, epileptic seizures, and an altered level of consciousness. Sympathetic activation due to complex pathophysiological processes may lead to extracerebral organ injury, including cardiac pathology, neurogenic pulmonary oedema, and acute kidney injury (AKI). The incidence of AKI in aSAH patients ranges from 16.3% to 25%. SAH patients who develop AKI have a poorer outcome and higher mortality. Uremic encephalopathy is a cerebral dysfunction caused by acute kidney injury and the accumulation of uremic toxins, resulting in an impaired level of consciousness and uremic coma. Therefore, AKI may mimic or worsen patients' neurological status. The diagnosis of uremic encephalopathy or coma is established after neurological improvement following dialysis.

Keywords

acute kidney injury (AKI); aneurysmatic subarachnoid haemorrhage; uremic coma; renal replacement therapy

Hrčak ID:

342441

URI

https://hrcak.srce.hr/342441

Publication date:

26.12.2025.

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