Study of renal function in patients of acute stroke and its relationship with in-hospital mortality

 

Sharanabasappa Nandyal¹, Nanda Nandyal^2*

 

Abstract              Background: Stroke being the disease of the elderly, has associated with high morbidity and mortality rate. It is increasingly apparent that individuals with chronic renal disease are more likely to die from cardio-cerebrovascular diseases. Stroke is an emergency disease and shares the same atherosclerotic risk factors with ischemic heart disease but the association of renal function and stroke is poorly investigated. In this study, we aimed to investigate the renal function in patients with acute stroke and its relationship with in-hospital mortality. Material and Methods: The present study was a prospective, observational study conducted in patients admitted to the hospital or reporting in OPD/Emergency, with clinical diagnosis of acute stroke, confirmed by CT scan / MRI. Glomerular filtration rate (eGFR) on admission was assessed using MDRD formula. Outcome in stroke patients was assessed in terms of mortality at 30 days since stroke episode. Results: 132 patients were considered for present study. Patients were divided into two groups as per eGFR. Group A with eGFR>60 and Group B with eGFR <60. 74% were from group A while 26% were from group B. Most patients were from >65 years age group, male, BMI<30. Hypertension, smoking, diabetes mellitus, cardiovascular disease, alcohol consumption, dyslipidemia, previous history of stroke/TIA were common risk factors in both groups. Maximum mortality was noted in >119 umol/L (41%) followed by 98-118 mmol (33%) serum creatinine group. While in blood urea group , maximum mortality was noted in >9 mmol/L (44%) followed by 6.8-8.9 mmol/L (30%). We noted that age > 65 years, GCS score > 10 at the time of admission, smoking, diabetes mellitus and aspiration pneumonitis were predictors of death in stroke patients. Conclusion: The severity of impaired kidney function in patients hospitalized with acute stroke is associated with increased mortality independent of age, sex, and major comorbidities. Unrecognized renal insufficiency noted by low eGFR is common in patients with acute stroke and is associated with higher mortality adverse short-term outcomes.

Key words: acute stroke, estimated glomerular filtration rate (eGFR), serum creatinine, blood urea.