---
title: "Base excess and alactic base excess predict KDIGO stage 2–3 AKI in acute ischemic stroke ICU patie"
id: "pubmed-42867193"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42867193"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42867193/"
doi: "10.5414/CN112097"
published_at: "2026-10-13T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Base excess and alactic base excess predict KDIGO stage 2–3 AKI in acute ischemic stroke ICU patie
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42867193
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42867193/)
- **DOI:** [10.5414/CN112097](https://doi.org/10.5414%2FCN112097)
- **Published At:** 2026-10-13T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The cohort comprised 1,377 adult patients with **acute ischemic stroke** identified from the **MIMIC-IV** database; 680 developed **KDIGO stage 2 - 3 acute kidney injury** during their ICU stay. - Investigators used univariable logistic regression to screen variables; bidirectional stepwise regression identified confounders for multivariable models. - Adjusted covariates listed in the abstract included **SOFA**, sodium, anticoagulants, furosemide, and aspirin; these were included when estimating adjusted odds. - A threshold association was reported for **base excess (BE)**: BE < -5.124 mmol/L was associated with increased odds of KDIGO stage 2 - 3 AKI (adjusted OR = 1.51, 95% CI 1.05–2.16). - For **alactic base excess (aBE)**, the unadjusted association was aBE < -3.444 mmol/L (OR = 1.57, 95% CI 1.12–2.20); in the adjusted model aBE < -3.444 mmol/L remained associated (adjusted OR = 1.43, 95% CI 1.00–2.04). - The team plotted restricted cubic splines and reported non-linear associations between both BE and aBE and KDIGO stage 2 - 3 AKI. - Subgroup analyses were stratified by age, Glasgow Coma Scale (GCS), **SOFA**, and comorbidities; a forest plot presented subgroup associations. - The abstract concludes that low BE or low aBE were associated with increased risk of moderate-to-severe AKI in AIS ICU patients. - The source did not report some procedural specifics in the abstract (for example, timing of arterial blood gas sampling, precise variable definitions, or external validation), and those details were not available in the abstract text.
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Online ahead of print. # Associations of base excess and alactic base excess with KDIGO stage 2 - 3 acute kidney injury in patients with acute ischemic stroke [Jieli Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+J&cauthor_id=42867193), [Zhenhua Xi](https://pubmed.ncbi.nlm.nih.gov/?term=Xi+Z&cauthor_id=42867193), [Weiliang Shi](https://pubmed.ncbi.nlm.nih.gov/?term=Shi+W&cauthor_id=42867193) * PMID: **42867193** * DOI: [ 10.5414/CN112097 ](https://doi.org/10.5414/cn112097) Item in Clipboard # Associations of base excess and alactic base excess with KDIGO stage 2 - 3 acute kidney injury in patients with acute ischemic stroke Jieli Wang et al. Clin Nephrol. 2026. Show details Display options Display options Format Abstract PubMed PMID Clin Nephrol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Clin+Nephrol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Clin+Nephrol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42867193/) . 2026 Oct 13. doi: 10.5414/CN112097. Online ahead of print. ### Authors [Jieli Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+J&cauthor_id=42867193), [Zhenhua Xi](https://pubmed.ncbi.nlm.nih.gov/?term=Xi+Z&cauthor_id=42867193), [Weiliang Shi](https://pubmed.ncbi.nlm.nih.gov/?term=Shi+W&cauthor_id=42867193) * PMID: **42867193** * DOI: [ 10.5414/CN112097 ](https://doi.org/10.5414/cn112097) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **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. 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