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Acute kidney injury in patients with cerebrovascular
stroke and its relationship to short-term mortality

Research Authors
Sherifa A. Hamed1, Ahmad H. Youssef1, Amal M. Tohamy1, Refaat F. Abd Elaal2, Mahmoud M. Hassan3
and Eman Nasr Eldin4
Research Department
Research Journal
International Research Journal of Medicine and Medical Sciences
Research Publisher
NULL
Research Rank
1
Research Vol
Vol. 3 - No. 3
Research Website
NULL
Research Year
2015
Research_Pages
pp. 70-77
Research Abstract

The adverse outcome after cerebrovascular stroke (CVS) is determined not only by the neurological deficits
but also by medical comorbidities including kidney dysfunction. We studied the frequency of acute kidney
injury (AKI) with CVS and its relationship to short-term mortality. This study included 80 patients with stroke
(mean age: 62.5 ± 6.2 years). Stroke severity was determined using Scandinavian Stroke Scale (SSS).
Serum creatinine (SCr), creatinine clearance (CrCl) and kidney injury molecule-1 (KIM-1) concentrations
were the measured markers of AKI. Follow-up was done for 3-months or till death. Cox proportional hazards
model was used to evaluate contributors to mortality. Compared to reference group, patients had higher SCr
(p < 0.05) and KIM-1 (p < 0.001) and lower CrCl (p < 0.01). The majority of patients (86.25%) had normal
SCr, while 57.5% had lower CrCl (<70 ml/min) and 92.5% had higher KIM-1 (>0.75 ng/ml). Mortality rate
was 35%. Compared to survivors, patients who died had lower SSS, higher SCr and KIM-1 and lower CrCl
(all p < 0.001). Higher SCr [Hazard ratio (HR), 1.65; 95% CI, 1.41 to 1.93], KIM-1 [HR, 1.63; 95%CI, 1.21 to
2.19] and lower CrCl [HR, 1.34; 95% CI, 1.09 to 1.65] significantly predicted worse short-term survival. We
conclude that AKI is a common complication of CVS. Increase in SCr, KIM-1 and decrease in CrCl
concentrations are associated with worse short-term outcome with stroke.