Key result
Renal dysfunction, including chronic kidney disease (0.9%) and end-stage renal disease (0.4%), was independently associated with in-hospital mortality in 186,219 patients with acute stroke.
Why the study?
Does renal dysfunction increase the risk of in-hospital mortality in patients hospitalized for acute stroke?
Observational (n=186,219)
Yes
Does renal dysfunction increase the risk of in-hospital mortality in patients hospitalized for acute stroke?
Renal dysfunction is a strong independent predictor of in-hospital mortality in patients with acute ischemic or hemorrhagic stroke, conferring higher risk than other established factors like atrial fibrillation.
Renal screening may aid prognostication in acute stroke; leaves open whether renal-targeted interventions improve survival.
Using a regional Italian database, we evaluated the relationship between renal dysfunction and in-hospital mortality (IHM) in patients with acute stroke (ischemic/hemorrhagic). Patients were classified on the basis of renal damage: without renal dysfunction, with chronic kidney disease (CKD), and with end-stage renal disease (ESRD). Of a total of 186,219 patients with a first episode of stroke, 1626 (0.9%) had CKD and 819 (0.4%) had ESRD. Stroke-related IHM (total cases) was independently associated with CKD, ESRD, atrial fibrillation (AF), age, and Charlson comorbidity index (CCI). In patients with ischemic stroke (n=154,026), IHM remained independently associated with CKD, ESRD, AF, and CCI. In patients with hemorrhagic stroke (n=32,189), variables that were independently associated with IHM were CKD, ESRD, and AF. Renal dysfunction is associated with IHM related to stroke, both ischemic and hemorrhagic, with even higher odds ratios than those of other established risk factors, such as age, comorbidities, and AF.
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Fabbian et al. (2013) conducted an observational in Acute stroke (ischemic/hemorrhagic) (n=186,219). Renal dysfunction (CKD and ESRD) vs. Without renal dysfunction was evaluated on In-hospital mortality (IHM). Renal dysfunction, including chronic kidney disease (0.9%) and end-stage renal disease (0.4%), was independently associated with in-hospital mortality in 186,219 patients with acute stroke.
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