Impact of renal dysfunction on clinical outcomes of acute ischemic stroke.
- Author:
Joon Seok CHOI
1
;
Ha Yeon KIM
;
Chan Young OAK
;
Min Jee KIM
;
Chang Sung KIM
;
Seul Hyun OH
;
Hyung Chul LEE
;
Jeong Woo PARK
;
Eun Hui BAE
;
Seong Kwon MA
;
Nam Ho KIM
;
Soo Wan KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. skimw@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Chronic kidney disease;
Acute ischemic stroke;
Mortality
- MeSH:
Coronary Artery Disease;
Diet;
Glomerular Filtration Rate;
Hospitalization;
Humans;
Odds Ratio;
Renal Insufficiency, Chronic;
Retrospective Studies;
Risk Factors;
Stroke
- From:Korean Journal of Medicine
2010;78(5):602-609
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Chronic kidney disease is recognized as an independent risk factor for coronary artery disease. It is unknown whether renal function predicts clinical outcomes of acute ischemic stroke. The present study was aimed at examining the correlation between the degree of renal dysfunction and stroke outcome. METHODS: Our retrospective study included 282 consecutive patients hospitalized due to acute ischemic stroke. Renal function was assessed by the estimated Glomerular filtration rate (GFR), using two METHODS: Cockcroft-Gault equation and Modification of Diet in Renal Disease (MDRD) equation. Each of the estimated GFRs were categorized into three groups (Group I: > or = 60 mL/min/1.73 m2, Group II: 45~59 mL/min/1.73 m2, Group III: 15~44 mL/min/1.73 m2). From collected patient databases, we compared mortality and rate of hospitalization to GFR at 1 month and 12 months follow up. RESULTS: Our study found that, based on the GFR, the 1 year mortality, using the Cockcroft-Gault equation, was 6.0% in group I, 20.3% in group II and 21.1% in group III and, using the MDRD equation, 9.1%, 12.5% and 37.5%, respectively. Patients with lower GFRs exhibited an increased odds ratio for 1 year mortality when estimated by the Cockcroft-Gault equation: 3.97 (1.7~9.2, 95% CI) in group II and 4.16 (1.2~14.5, 95% CI) in group III. Based on the MDRD equation, patients with lower GFRs also exhibited an increased odds ratio for 1-year mortality: 1.43 (0.5~4.4, 95% CI) in group II and 6.00 (1.3~26.8, 95% CI) in group III. The adjusted odds ratio for 1-year mortality also increased based on our analysis using either equation. CONCLUSIONS: Decline of GFR and severity of chronic kidney disease are associated with poor clinical outcomes of acute ischemic stroke.
