Acute Kidney Injury in Patients with Acute Stroke
Iraqi Postgraduate Medical Journal,
2019, Volume 18, Issue 3, Pages 234-241
According to world health organization, about 15 million people suffer from stroke worldwide each
year. Acute kidney injury complicates 5-7% of acute care hospital admissions and up to 30% of
critical care patients. These in turn lead to increase disability, decreased quality of life and
disproportionate burden on healthcare resources. Patients admitted for diagnosis and treatment
of acute stroke are at high risk of developing acute kidney injury due to comorbid conditions, poor
oral intake and exposure to nephrotoxic agents.
to determine the incidence of acute kidney injury in patients admitted with acute stroke and
evaluates associated comorbidities and possible risk factors.
PATIENTS AND METHODS:
in a cross-sectional study, a cohort of 436 patients admitted with acute stroke, (327 with ischemic
stroke and 109 with intracerebral hemorrhage) entailed in this study.
Serum creatinine readings using Jaffe method was obtained at first day of insult, after 48 hours and 7
days after onset of stroke, KDIGO criteria was used to define patients who developed acute kidney
injury which include elevation of serum creatinine of 0.3 mgdl or more within 48 hours or 1.5 fold
or more increment of baseline serum creatinine within 7 days.
Acute kidney injury was a common complication in acute stroke population with total incidence
13.5%, with significantly higher incidence in intracerebral hemorrhage group (22.9%) than in
ischemic group (10.4%) p=0.000919. The study also show significant sex difference with higher
incidence in males than females in ischemic group (13.4% vs 6.7%; p= 0.049) intracerebral
hemorrhage group (31.5% vs 12.3%; p=0.0246).
Study also shows significant relation between developing acute kidney injury and history of
hypertension in both groups with p=0.00229, and significant relation with diabetes mellitus
Study shows that there is significant elevation of serum creatinine on consecutive measures between
first day and day 7 with p=0.000.
We found that there is significant direct relation between increasing age and incidence of acute
kidney injury with p=0.040 in ischemic group and p= 0.015 in intracerebral hemorrhage group.
The incidence of acute kidney injury in acute stroke patients was 13.5% with significantly higher
incidence in intracerebral hemorrhage group with significant relation between development of acute
kidney injury and being male, has hypertension, diabetes mellitus or advance age.
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