Frequency of kidney dysfunction in patients with acute stroke and the relationship with the type, severity and outcome.

Abstract

Background/aim: Kidney dysfunction is an established risk factor for cardiovascular diseases including stroke. The study aimed at assessing the frequency of kidney dysfunction in patients with acute stroke and to evaluate the relationship to the type, severity and outcome of stroke. To establish a relationship, which has not been explained in past studies.

Materials and methods: This was a cross-sectional analytical study on acute stroke patients and matched controls, evaluating for kidney dysfunction using both estimated glomerular filtration rate (GFR) and the spot urine protein creatinine ratio. The type of stroke was observed by neuroimaging. The National Institute of Health Stroke Score was used to assess the severity of stroke at presentation and outcome after 7 days. Data analysis was done using Statistical Package for Social Sciences (SPSS) application version 23.0 (SPSS Inc., Chicago, IL, USA).

Results: : Ninety-eight patients and 100 controls were recruited, with a mean age of 64.7 ± 15.5 and 64.8 ± 15.1 years, respectively. The patients with stroke had a statistically significant higher frequency of kidney dysfunction compared to the controls (85.9% vs. 62.0%, P ≤ 0.001). Patients with haemorrhagic stroke had a higher frequency of kidney dysfunction compared with those with ischaemic stroke (93.8% vs. 77.3%, P = 0.048). The proportion of patients with kidney dysfunction was seen to increase from those with mild to those with severe stroke symptoms, both at presentation and after 7 days. Estimated GFR was seen to be an independent predictor of poor outcome in patients with stroke (odds ratio 0.955, 95% confidence interval 0.924 - 0.986, P = 0.005).

Conclusion: The study demonstrated that in patients with acute stroke there is a high frequency of kidney dysfunction. Haemorrhagic stroke, increasing stroke severity and poor outcome were seen to be associated with kidney dysfunction. Thus, recommending the need for kidney care as an important part of stroke management.