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Renal dysfunction in acute stroke: an independent predictor of long-term all combined vascular events and overall

George Tsagalis1, Theodore Akrivos, Maria Alevizaki

  • 11Renal Unit, Alexandra Hospital, University of Athens, Athens, Greece. tsagalis@otenet.gr

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 30, 2008
PubMed

Insights

Reduced kidney function in acute stroke patients significantly increases long-term mortality and cardiovascular event risk. This highlights the prognostic importance of assessing estimated Glomerular Filtration Rate (eGFR) upon admission for better patient outcomes.

Area of Science:

  • Nephrology
  • Neurology
  • Cardiology

Background:

  • Acute stroke is a leading cause of death, sharing risk factors with ischemic heart disease.
  • The prognostic role of renal function in acute stroke patients remains under-investigated.
  • This study assesses renal function in acute stroke patients and its impact on outcomes.

Purpose of the Study:

  • To evaluate the association between renal function, assessed by estimated Glomerular Filtration Rate (eGFR), and outcomes in acute stroke patients.
  • To investigate the prognostic significance of renal dysfunction on long-term mortality and cardiovascular events.
  • To determine if eGFR is an independent predictor of stroke outcomes.

Main Methods:

  • Prospective study of 1350 first-ever stroke patients hospitalized within 24 hours.
  • Patients categorized into three groups based on eGFR (Group A: >60, Group B: 30-60, Group C: <30 ml/min/1.73 m²).
  • Exclusion of patients with Acute Kidney Injury (AKI); follow-up for 1-120 months to assess mortality and composite cardiovascular events.

Main Results:

  • 28.08% of patients presented with moderate to severe renal dysfunction (eGFR <60).
  • Reduced eGFR was an independent predictor of 10-year mortality, with significantly higher risks in Groups B and C compared to Group A.
  • Patients with lower eGFR showed a significantly higher probability of both all-cause mortality and new cardiovascular events during follow-up.

Conclusions:

  • Renal function at admission is a significant independent prognostic factor for acute stroke patients.
  • Impaired renal function predicts long-term mortality and increased cardiovascular morbidity over a 10-year period.
  • Assessment of eGFR is crucial for risk stratification and management of acute stroke.
Abstract

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