The impact of acute kidney injury on fatality of ischemic stroke from a hospital-based population in Joinville, Brazil

The impact of acute kidney injury on fatality of ischemic stroke from a hospital-based population in Joinville, Brazil

The occurrence of acute kidney injury (AKI) after ischemic stroke has been associated to a worse prognosis. There is a lack of Brazilian studies evaluating this issue. This study aimed to describe the impact of AKI after a first-ever ischemic stroke in relation to fatality rate in 30 days. This was...

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Bibliographic Details
Published in:Brazilian Journal of Nephrology Vol. 41; no. 3; pp. 323 - 329
Main Authors: Lima, Helbert do Nascimento, Saibel, Tais, Colato, Gisele, Cabral, Norberto Luiz
Format: Journal Article
Language:English
Published: Brazil Sociedade Brasileira de Nefrologia 01-07-2019
Subjects:
Acute Kidney Injury
Acute Kidney Injury - epidemiology
Acute Kidney Injury - etiology
Aged
Aged, 80 and over
Brain Ischemia - complications
Brain Ischemia - mortality
Brazil - epidemiology
Creatinine - blood
Female
Hospital Mortality
Hospitalization
Humans
Kaplan-Meier Estimate
Kidney Function Tests
Male
Middle Aged
Original
Prevalence
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Stroke
Stroke - complications
Stroke - mortality
Survival
Brazil
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Summary:The occurrence of acute kidney injury (AKI) after ischemic stroke has been associated to a worse prognosis. There is a lack of Brazilian studies evaluating this issue. This study aimed to describe the impact of AKI after a first-ever ischemic stroke in relation to fatality rate in 30 days. This was a retrospective hospital-based cohort. We included patients who had their first ischemic stroke between January to December 2015. AKI was defined by an increase of serum creatinine in relation to baseline value at admission ≥ 0.3 mg/dL or a rise in serum creatinine level by 1.5 times the baseline value at any point in the first week after admission. We performed a univariate and multivariate analysis to evaluate the presence of AKI with fatality in 30 days. The final study population (n=214) had mean age of 66.46 ± 13.73 years, 48.1% were men, the mean NIHSS was 6.33 ± 6.27 and 20 (9.3%) presented AKI. Patients with AKI were older, had a higher score on the NIHSS, and had higher creatinine values on hospital discharge. The 30-day mortality was higher in the AKI subgroup compared to non-AKI (35% vs. 6.2%, p < 0.001). AKI was an independent predictor of fatality after an ischemic stroke but limited by severity of stroke (NIHSS). The presence of AKI is an important complication after ischemic stroke. Despite its impact on 30-day fatality, the predictive strength of AKI was limited by the severity of stroke.
ISSN:0101-2800
2175-8239
2175-8239
DOI:10.1590/2175-8239-JBN-2018-0215