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Association between renal function and clinical outcome in patients with acute stroke.
Eur Neurol. 2010; 63(4):237-42.EN

Abstract

BACKGROUND AND PURPOSE

Data on the association between renal dysfunction and outcome in patients with stroke are controversial and scarce. We investigated the predictors of renal dysfunction upon admission and the association between renal dysfunction and clinical outcome in patients with acute stroke in a hospitalized Chinese population.

METHODS

1,758 acute stroke patients were consecutively enrolled into the study. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease equation. Reduced estimate of the glomerular filtration rate was defined as eGFR <60 ml/min/1.73 m(2). Multivariate logistical regression was used to evaluate the predictors of renal dysfunction upon admission and to examine the association between renal dysfunction and outcomes. The main outcome measures were death and death/disability (disability defined as modified Rankin Scale score >2) at 12 months after stroke.

RESULTS

Of the included 1,758 cases (ischemic stroke: n = 1,192; hemorrhagic stroke: n = 566), 463 cases had reduced eGFR, which accounted for 26.3% of the total number. The distribution of eGFR upon admission was normal and the mean was 75.87 +/- 38.31 ml/min/1.73 m(2) (ischemic stroke: 75.07 +/- 29.89 ml/min/1.73 m(2); hemorrhagic stroke: 77.57 +/- 51.73 ml/min/1.73 m(2)). There was no significant difference between the two groups (p = 0.285). The independent predictors of eGFR upon admission were age (OR = 1.039, 95% CI = 1.028-1.050), male gender (OR = 0.658, 95% CI = 0.504-0.859), hematocrit on admission (OR = 1.008, 95% CI = 1.003-1.013), history of hypertension (OR = 1.307, 95% CI = 1.034-1.653), history of diabetes (OR = 1.411, 95% CI = 1.012-1.967) and NIHSS scores upon admission (OR = 1.497, 95% CI = 1.286-1.743). After adjustment for confounders, the patients with renal dysfunction had a significantly higher risk of death/disability (OR = 1.864, 95% CI = 1.170-2.970) compared with patients whose eGFR was more than 90 ml/min/1.73 m(2) at the end of the 12th month. Further analysis on type of stroke showed that reduced eGFR was an independent predictor of death/disability at the end of the 12th month in patients with hemorrhagic stroke (OR = 2.353, 95% CI = 1.063-5.209), but not for ischemic stroke (OR = 1.625, 95% CI = 0.881-2.999).

CONCLUSIONS

Our study indicated that more than 1/4 of all patients with acute stroke presented with renal dysfunction. Reduced eGFR on admission is a strong predictor of poor outcome for hemorrhagic stroke but not for ischemic stroke.

Authors+Show Affiliations

Department of Neurology, West China Hospital, Sichuan University, Chengdu, PR China.No 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

20332640

Citation

Hao, Zilong, et al. "Association Between Renal Function and Clinical Outcome in Patients With Acute Stroke." European Neurology, vol. 63, no. 4, 2010, pp. 237-42.
Hao Z, Wu B, Lin S, et al. Association between renal function and clinical outcome in patients with acute stroke. Eur Neurol. 2010;63(4):237-42.
Hao, Z., Wu, B., Lin, S., Kong, F. Y., Tao, W. D., Wang, D. R., & Liu, M. (2010). Association between renal function and clinical outcome in patients with acute stroke. European Neurology, 63(4), 237-42. https://doi.org/10.1159/000285165
Hao Z, et al. Association Between Renal Function and Clinical Outcome in Patients With Acute Stroke. Eur Neurol. 2010;63(4):237-42. PubMed PMID: 20332640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between renal function and clinical outcome in patients with acute stroke. AU - Hao,Zilong, AU - Wu,Bo, AU - Lin,Sen, AU - Kong,Fan-Yi, AU - Tao,Wen-Dan, AU - Wang,De-Ren, AU - Liu,Ming, Y1 - 2010/03/24/ PY - 2009/11/12/received PY - 2010/02/05/accepted PY - 2010/3/25/entrez PY - 2010/3/25/pubmed PY - 2010/7/14/medline SP - 237 EP - 42 JF - European neurology JO - Eur Neurol VL - 63 IS - 4 N2 - BACKGROUND AND PURPOSE: Data on the association between renal dysfunction and outcome in patients with stroke are controversial and scarce. We investigated the predictors of renal dysfunction upon admission and the association between renal dysfunction and clinical outcome in patients with acute stroke in a hospitalized Chinese population. METHODS: 1,758 acute stroke patients were consecutively enrolled into the study. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease equation. Reduced estimate of the glomerular filtration rate was defined as eGFR <60 ml/min/1.73 m(2). Multivariate logistical regression was used to evaluate the predictors of renal dysfunction upon admission and to examine the association between renal dysfunction and outcomes. The main outcome measures were death and death/disability (disability defined as modified Rankin Scale score >2) at 12 months after stroke. RESULTS: Of the included 1,758 cases (ischemic stroke: n = 1,192; hemorrhagic stroke: n = 566), 463 cases had reduced eGFR, which accounted for 26.3% of the total number. The distribution of eGFR upon admission was normal and the mean was 75.87 +/- 38.31 ml/min/1.73 m(2) (ischemic stroke: 75.07 +/- 29.89 ml/min/1.73 m(2); hemorrhagic stroke: 77.57 +/- 51.73 ml/min/1.73 m(2)). There was no significant difference between the two groups (p = 0.285). The independent predictors of eGFR upon admission were age (OR = 1.039, 95% CI = 1.028-1.050), male gender (OR = 0.658, 95% CI = 0.504-0.859), hematocrit on admission (OR = 1.008, 95% CI = 1.003-1.013), history of hypertension (OR = 1.307, 95% CI = 1.034-1.653), history of diabetes (OR = 1.411, 95% CI = 1.012-1.967) and NIHSS scores upon admission (OR = 1.497, 95% CI = 1.286-1.743). After adjustment for confounders, the patients with renal dysfunction had a significantly higher risk of death/disability (OR = 1.864, 95% CI = 1.170-2.970) compared with patients whose eGFR was more than 90 ml/min/1.73 m(2) at the end of the 12th month. Further analysis on type of stroke showed that reduced eGFR was an independent predictor of death/disability at the end of the 12th month in patients with hemorrhagic stroke (OR = 2.353, 95% CI = 1.063-5.209), but not for ischemic stroke (OR = 1.625, 95% CI = 0.881-2.999). CONCLUSIONS: Our study indicated that more than 1/4 of all patients with acute stroke presented with renal dysfunction. Reduced eGFR on admission is a strong predictor of poor outcome for hemorrhagic stroke but not for ischemic stroke. SN - 1421-9913 UR - https://www.unboundmedicine.com/medline/citation/20332640/Association_between_renal_function_and_clinical_outcome_in_patients_with_acute_stroke_ L2 - https://www.karger.com?DOI=10.1159/000285165 DB - PRIME DP - Unbound Medicine ER -