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Long-term prognosis of acute kidney injury after first acute stroke.
Clin J Am Soc Nephrol. 2009 Mar; 4(3):616-22.CJ

Abstract

BACKGROUND AND OBJECTIVES

Acute kidney injury (AKI) has been associated with increased mortality in a variety of clinical settings. We studied the incidence, predictors, and effect of AKI on long-term overall mortality and cardiovascular events after stroke.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

This was a prospective outcome study of 2155 patients who sustained an acute first-ever stroke and were followed for 10 yr. Patients were divided in two groups: (1) Those with an acute increase (over 48 h) in serum creatinine >or=0.3 mg/dl or a percentage increase of >or=50% and (2) those with a change <0.3 mg/dl, no change at all, or even a reduction.

RESULTS

Twenty-seven percent of patients developed AKI after acute stroke. Stroke severity, baseline estimated GFR, heart failure, and stroke subtype predict the occurrence of AKI. The probability of 10-yr mortality for patients with AKI was 75.9 and 57.7 in the patients without AKI (log rank test 45.0; P = 0.001). When patients with AKI were subdivided into three groups according to AKI severity, the probability of 10-yr mortality increased: 73.7, 86.5, and 89.2 in stages 1, 2, and 3, respectively. In Cox proportional hazard analysis, AKI was an independent predictor of 10-yr mortality (P < 0.01) and for the occurrence of new composite cardiovascular events (P < 0.05) after adjustment for available confounding variables.

CONCLUSIONS

AKI after stroke is a powerful and independent predictor of 10-yr mortality and new composite cardiovascular events.

Authors+Show Affiliations

Renal Unit, Alexandra Hospital, University of Athens, Athens, Greece. tsagalis@otenet.grNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19211666

Citation

Tsagalis, George, et al. "Long-term Prognosis of Acute Kidney Injury After First Acute Stroke." Clinical Journal of the American Society of Nephrology : CJASN, vol. 4, no. 3, 2009, pp. 616-22.
Tsagalis G, Akrivos T, Alevizaki M, et al. Long-term prognosis of acute kidney injury after first acute stroke. Clin J Am Soc Nephrol. 2009;4(3):616-22.
Tsagalis, G., Akrivos, T., Alevizaki, M., Manios, E., Theodorakis, M., Laggouranis, A., & Vemmos, K. N. (2009). Long-term prognosis of acute kidney injury after first acute stroke. Clinical Journal of the American Society of Nephrology : CJASN, 4(3), 616-22. https://doi.org/10.2215/CJN.04110808
Tsagalis G, et al. Long-term Prognosis of Acute Kidney Injury After First Acute Stroke. Clin J Am Soc Nephrol. 2009;4(3):616-22. PubMed PMID: 19211666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term prognosis of acute kidney injury after first acute stroke. AU - Tsagalis,George, AU - Akrivos,Theodore, AU - Alevizaki,Maria, AU - Manios,Efstathios, AU - Theodorakis,Michael, AU - Laggouranis,Antonios, AU - Vemmos,Konstantinos N, Y1 - 2009/02/11/ PY - 2009/2/13/entrez PY - 2009/2/13/pubmed PY - 2009/6/3/medline SP - 616 EP - 22 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 4 IS - 3 N2 - BACKGROUND AND OBJECTIVES: Acute kidney injury (AKI) has been associated with increased mortality in a variety of clinical settings. We studied the incidence, predictors, and effect of AKI on long-term overall mortality and cardiovascular events after stroke. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a prospective outcome study of 2155 patients who sustained an acute first-ever stroke and were followed for 10 yr. Patients were divided in two groups: (1) Those with an acute increase (over 48 h) in serum creatinine >or=0.3 mg/dl or a percentage increase of >or=50% and (2) those with a change <0.3 mg/dl, no change at all, or even a reduction. RESULTS: Twenty-seven percent of patients developed AKI after acute stroke. Stroke severity, baseline estimated GFR, heart failure, and stroke subtype predict the occurrence of AKI. The probability of 10-yr mortality for patients with AKI was 75.9 and 57.7 in the patients without AKI (log rank test 45.0; P = 0.001). When patients with AKI were subdivided into three groups according to AKI severity, the probability of 10-yr mortality increased: 73.7, 86.5, and 89.2 in stages 1, 2, and 3, respectively. In Cox proportional hazard analysis, AKI was an independent predictor of 10-yr mortality (P < 0.01) and for the occurrence of new composite cardiovascular events (P < 0.05) after adjustment for available confounding variables. CONCLUSIONS: AKI after stroke is a powerful and independent predictor of 10-yr mortality and new composite cardiovascular events. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/19211666/Long_term_prognosis_of_acute_kidney_injury_after_first_acute_stroke_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=19211666 DB - PRIME DP - Unbound Medicine ER -