The impact of acute kidney injury on short-term survival in an Eastern European population with stroke

Abstract

The mean age of this population was 66.1 +/- 11.5 years, 49.3% were males, mean glomerular filtration rate (GFR) 68.9 +/- 22.6 ml/min/1.73 m(2). The 30-day mortality rate was 17.2%. One hundred and fifty-eight patients presented with haemorrhagic stroke and 932 patients had ischaemic stroke. Stroke mortality was-14% for ischaemic stroke and almost twice as high for haemorrhagic stroke-36.3%. One hundred fifty-eight (14.5%) patients were classified as developing AKI. The AKI patients were older, had a higher baseline serum creatinine, lower GFR, higher serum glucose, higher prevalence of chronic heart failure and ischaemic heart disease, were more likely to have suffered a haemorrhagic stroke, and had a significantly higher 30-day mortality rate (43.1 vs 12.8%) (P < 0.05 for all). Independent predictors for AKI development in the logistic regression analysis were age, GFR, presence of comorbidities (ischaemic heart disease and chronic heart failure) and type of stroke (Cox and Snell R(2) 0.244; Nagelkerke R(2) 0.431; P < 0.05). In our study, we demonstrated that the occurrence of AKI is not a rare finding in stroke patients. This is the first study to report the incidence of AKI in a distinct geographic population base, in patients with stroke. Baseline renal function emerged as both a significant independent marker for short-term survival after an acute stroke (even after adjustment for baseline comorbidities) and as a risk factor for subsequent AKI.

Acute kidney injury is a common complication after acute stroke in Mymensingh Medical College Hospital

“…Majority of the study subjects, (128, 53.33%) and majority of the AKI patients (20, 54.05%) belonged to > 60 years age group. ese ndings were comparable to the study of Covic et al, 2008. ey have showed in their study that the mean age of the study subjects was 66.1±11.5 years.…”

Cerebral Small Vessel Disease and Kidney Function Predict Long-Term Survival in Patients With Acute Stroke

“…It must be emphasized that there are several causes of decreased eGFR; it could represent acute dehydration on admission, a concurrent infection, or renal artery stenosis as well as small vessel renovascular disease. Because acute renal failure itself is an independent prognostic factor for mortality after stroke, 40 our results may underestimate the prognostic value of chronically lowered eGFR. To avoid bias from low eGFR (Ͻ30 mL/min/1.73 m 2 ), 5 patients were excluded from the analysis.…”

Long-Term Prognosis of Acute Kidney Injury after First Acute Stroke

“…Only a recent retrospective study investigated the incidence and characteristics of AKI in patients with stroke in an Eastern European population and its role on short-term mortality (20). The authors reported a 14.5% incidence of AKI that was associated with an increased 30-d mortality (43.1 versus 12.8% in patients without AKI).…”