Dados do Trabalho

Título

Impact of in-hospital Acute Kidney Injury on Death or Functional Dependency After Stroke

Resumo

Background: Renal dysfunction and acute kidney injury (AKI) have been identified as a risk factor to worse outcomes in the general population of intensive care units. According to previous studies, AKI has been a frequent complication after an acute cerebrovascular event, with an overall prevalence around 11.6%. Our aim is to evaluate the impact of AKI during hospitalization on stroke patients.

Methods: Prospective cohort of stroke patients with symptom onset within 72 hours before research admission. AKI was diagnosed by the occurrence of an increase in the serum creatinine level by approximately 0.4 mg/dl in less than 72 hours during hospitalization for ischemic or hemorrhagic stroke. Our main outcome was functional dependence or death, evaluated by modified Rankin Scale (mRS), at 90 days post-ictus.

Results: Two hundred and fifty one patients were enrolled. AKI was diagnosed in 78 (37.1) patients. The frequency of death or functional dependence (mRS> 2) was lower among those who were not diagnosed with acute kidney injury [U = 4.523; 38 (48.7) vs 40 (51.3) cases, p=0.033]. However, multivariate analysis failed to show the occurrence of AKI as independent predictor of mRS > 2 in 90 days (odds ratio, 1.19 [IC 95%, 1.13-1.25]), which was observed to variables as age, sex, National Institutes of Health Stroke Scale on admission, type of stroke, pre-ictus mRS score and infection occurence.

Conclusion: Our study suggests that, although in-hospital acute kidney injury may be associated with worse outcomes in stroke patients, we were not able to describe it as an independent predictor. That conclusion indicates there may be unknown variables, which our data was not able to detect, that can influence this association.

Palavras Chave

Stroke; Acute Kidney Injury; Functional Dependency