Clinical features and neurologic severity in stroke patients with mild to moderate renal dysfunction

To evaluate the independent effect of moderate renal dysfunction on stroke severity and to disclose the clinical features of stroke patients with moderate renal dysfunction.

We studied consecutive stroke patients presenting within 48 hours of onset. The National Institutes of Health Stroke Scale (NIHSS) score at the time of presentation was used as an index of stroke severity. Patients were categorized into 2 groups based on their estimated glomerular filtration rates (eGFRs).

Of the 475 patients with an eGFR >15 mL per minute per 1.73 m(2), 158 patients (33.3%) had an eGFR <60 mL per minute per 1.73 m(2). These patients were older and included significantly more cases with hypertension and atrial fibrillation. The NIHSS score at the time of admission was higher among the patients with renal dysfunction. In a multivariable model with adjustments for other clinical background factors, moderate renal dysfunction was an independent predictor of the neurologic severity of stroke at the time of admission (odds ratio, 1.261; 95% confidence interval, 1.032-1.545; P = .0244).

Stroke patients with moderate renal dysfunction had a higher prevalence of hypertension and atrial fibrillation. Moderate renal dysfunction was associated with a higher severity of stroke on admission.