A Low Baseline Glomerular Filtration Rate Predicts Poor Clinical Outcome at 3 Months after Acute Ischemic Stroke
Journal of Clinical Neurology
;
: 73-79, 2015.
Article
in English
| WPRIM
| ID: wpr-179195
ABSTRACT
BACKGROUND AND PURPOSE:
Chronic kidney disease (CKD) is an established risk factor for numerous cardiovascular diseases including stroke. The relationship between the baseline estimated glomerular filtration rate (eGFR) and clinical 3-month outcomes in patients with acute ischemic stroke were evaluated in this study.METHODS:
This was a prospective cohort study involving a hospital-based stroke registry; 1373 patients with acute ischemic stroke were enrolled. Patients were divided into the following four groups according their eGFR (calculated using the CKD Epidemiology Collaboration equations) > or =60, 45-59, 30-44, and or =3); secondary endpoints were neurological deterioration (increase in National Institutes of Health Stroke Severity score of > or =4 at discharge compared to baseline) during hospitalization and in-hospital mortality.RESULTS:
The overall eGFR was 84.5+/-20.8 mL/min/1.73 m2 (mean+/-SD). The distribution of baseline renal impairment was as follows 1,218, 82, 40, and 33 patients had eGFRs of > or =60, 45-59, 30-44, and <30 mL/min/1.73 m2, respectively. At 3 months after the stroke, 476 (34.7%) patients exhibited poor functional outcome. Furthermore, a poor functional outcome occurred more frequently with increasingly advanced stages of CKD (rates of 31.9%, 53.7%, 55.0%, and 63.6% for CKD stages 1/2, 3a, 3b, and 4/5, respectively; p<0.001). Multivariate analysis revealed that a baseline eGFR of <30 mL/min/1.73m2 increased the risk of a poor functional outcome by 2.37-fold (p=0.047). In addition, baseline renal dysfunction was closely associated with neurological deterioration during hospitalization and with in-hospital mortality.CONCLUSIONS:
A low baseline eGFR was strongly predictive of both poor functional outcome at 3 months after ischemic stroke and neurological deterioration/mortality during hospitalization.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Cardiovascular Diseases
/
Epidemiology
/
Multivariate Analysis
/
Prospective Studies
/
Risk Factors
/
Cohort Studies
/
Mortality
/
Hospital Mortality
/
Cooperative Behavior
/
Stroke
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Journal of Clinical Neurology
Year:
2015
Type:
Article
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