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Updated: Apr 18, 2026
Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat
Published on: July 26, 2015
A low baseline glomerular filtration rate predicts poor clinical outcome at 3 months after acute ischemic stroke
Hyung Jik Kim1, Jwa-Kyung Kim1, Mi Sun Oh2
1Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Insights
Lower estimated glomerular filtration rate (eGFR) significantly predicts poor outcomes in acute ischemic stroke patients. Reduced kidney function is linked to worse functional status, neurological decline, and mortality post-stroke.
Area of Science:
- Nephrology
- Neurology
- Cardiovascular Disease
Background:
- Chronic kidney disease (CKD) is a known risk factor for cardiovascular diseases, including stroke.
- The impact of baseline kidney function on acute ischemic stroke outcomes requires further investigation.
Purpose of the Study:
- To evaluate the relationship between baseline estimated glomerular filtration rate (eGFR) and 3-month clinical outcomes in patients with acute ischemic stroke.
- To assess the association between varying levels of renal function and stroke recovery.
Main Methods:
- Prospective cohort study of 1373 patients with acute ischemic stroke from a hospital-based registry.
- Patients categorized into four groups based on baseline eGFR: ≥60, 45-59, 30-44, and <30 mL/min/1.73 m².
- Primary outcome: poor functional outcome at 3 months (death or dependency); secondary outcomes: neurological deterioration and in-hospital mortality.
Main Results:
- A significant proportion of patients (34.7%) experienced poor functional outcomes at 3 months.
- Poor functional outcomes increased with advanced stages of CKD (p<0.001).
- A baseline eGFR <30 mL/min/1.73 m² was associated with a 2.37-fold increased risk of poor functional outcome (p=0.047) and correlated with neurological deterioration and in-hospital mortality.
Conclusions:
- Low baseline eGFR is a strong predictor of poor functional outcomes 3 months post-ischemic stroke.
- Reduced kidney function is also associated with increased neurological deterioration and mortality during hospitalization.
Background And Purpose:
Chronic kidney disease (CKD) is an established risk factor for numerous cardiovascular diseases including stroke. The relationship between the baseline estimated glomerular filtration rate (eGFR) and clinical 3-month outcomes in patients with acute ischemic stroke were evaluated in this study.
Methods:
This was a prospective cohort study involving a hospital-based stroke registry; 1373 patients with acute ischemic stroke were enrolled. Patients were divided into the following four groups according their eGFR (calculated using the CKD Epidemiology Collaboration equations): ≥60, 45-59, 30-44, and <30 mL/min/1.73 m(2). The primary endpoint of poor functional outcome was defined as 3-month death or dependency (modified Rankin Scale score ≥3); secondary endpoints were neurological deterioration (increase in National Institutes of Health Stroke Severity score of ≥4 at discharge compared to baseline) during hospitalization and in-hospital mortality.
Results:
The overall eGFR was 84.5±20.8 mL/min/1.73 m(2) (mean±SD). The distribution of baseline renal impairment was as follows: 1,218, 82, 40, and 33 patients had eGFRs of ≥60, 45-59, 30-44, and <30 mL/min/1.73 m(2), respectively. At 3 months after the stroke, 476 (34.7%) patients exhibited poor functional outcome. Furthermore, a poor functional outcome occurred more frequently with increasingly advanced stages of CKD (rates of 31.9%, 53.7%, 55.0%, and 63.6% for CKD stages 1/2, 3a, 3b, and 4/5, respectively; p<0.001). Multivariate analysis revealed that a baseline eGFR of <30 mL/min/1.73m(2) increased the risk of a poor functional outcome by 2.37-fold (p=0.047). In addition, baseline renal dysfunction was closely associated with neurological deterioration during hospitalization and with in-hospital mortality.
Conclusions:
A low baseline eGFR was strongly predictive of both poor functional outcome at 3 months after ischemic stroke and neurological deterioration/mortality during hospitalization.
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