01Jan 2017

BASELINE RENAL DYSFUNCTION IN ACUTE ISCHEMIC STROKE PATIENTS: PREVALENCE AND IMPACT ON EARLY MORTALITY.

  • Department of Internal Medicine, Zagazig University; Egypt. Department of Neurology, Zagazig University; Egypt.
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Abstract


Introduction: Stroke is considered the second leading cause of death globally. Chronic kidney disease (CKD) has been identified as a risk factor for stroke. However, little is known about the impact of renal dysfunction on early mortality following acute ischemic stroke. The aim of the current study was to evaluate the prevalence of renal dysfunction among acute ischemic stroke patients and its role on the early overall mortality. Patients and methods: This prospective cohort study included a total of 889 patients with first ever ischemic stroke who were hospitalized within 24 hours of symptoms onset. All patients were clinically evaluated to determine stroke risk factors. Stroke severity was assessed using National Institute of Health Stroke Scale (NIHSS) in the 1st day of admission. Baseline investigations were obtained within 24 hours of admission, including serum creatinine and estimated Glomerular Filtration Rate (eGFR) that was calculated from the equation of the Modification Diet for Renal Disease in ml/min/1.73m2. Patients were followed up for 30 days after admission or at least until death. Results: Of the 800 stroke patients who completed follow up during the study period, 242 (30.2%) had renal dysfunction, and 128 (16%) died within 30-days of stroke onset, whereas mortality was higher (19.8%) in patients with eGFR <60 ml/min/1.73m2 than in patients (14%) with eGFR ?60 ml/min/1.73m2. In multivariate analysis, 30–days mortality risk of stroke was higher in patients with eGFR< 60ml/min/1.73 m2 (HR= 1.7, 95% CI=1.4–2, P=0.002), stroke severity (HR= 1.5, 95% CI=1.3- 1.7, P=0.001), and presence of atrial fibrillation (HR= 1.4, 95% CI=1.1-1.7, P=0.007). Meanwhile, the odds of mortality risk increased by 1.7 for each 1 mg/dl increase in baseline serum creatinine. Conclusion: The prevalence of renal dysfunction in our cohort of acute ischemic stroke patients was high. Presence of baseline renal dysfunction was recorded as an independent predictor of early mortality in the setting of acute ischemic stroke beside other well-known prognostic factors.


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Cite This Article as:


[Medhat I. Mahmoud, Ahmed E. Badawy, Nahed Shehta and Bothina M. Ramadan. (2017); BASELINE RENAL DYSFUNCTION IN ACUTE ISCHEMIC STROKE PATIENTS: PREVALENCE AND IMPACT ON EARLY MORTALITY. Int. J. of Adv. Res. 5 (1). 502-508] (ISSN 2320-5407). www.journalijar.com


DOI:


Article DOI: 10.21474/IJAR01/2774       DOI URL: http://dx.doi.org/10.21474/IJAR01/2774


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