Korean J Med > Volume 78(5); 2010 > Article
The Korean Journal of Medicine 2010;78(5):602-610.
Impact of renal dysfunction on clinical outcomes of acute ischemic stroke
Joon Seok Choi, Ha Yeon Kim, Chan Young Oak, Min Jee Kim, Chang Sung Kim, Seul Hyun Oh, Hyung Chul Lee, Jeong Woo Park, Eun Hui Bae, Seong Kwon Ma, Nam Ho Kim, Soo Wan Kim
만성 신장 질환이 급성 허혈성 뇌졸중의 예후에 미치는 영향
최준석, 김하연, 옥찬영, 김민지, 김창성, 오슬현, 이형철, 박정우, 배은희, 마성권, 김남호, 김수완
Abstract
Background/Aims: Chronic kidney disease is recognized as an independent risk factor for coronary artery disease. It is unknown whether renal function predicts clinical outcomes of acute ischemic stroke. The present study was aimed at examining the correlation between the degree of renal dysfunction and stroke outcome. Methods: Our retrospective study included 282 consecutive patients hospitalized due to acute ischemic stroke. Renal function was assessed by the estimated Glomerular filtration rate (GFR), using two methods: Cockcroft-Gault equation and Modification of Diet in Renal Disease (MDRD) equation. Each of the estimated GFRs were categorized into three groups (Group I: ≥60 mL/min/1.73 m2, Group II: 45~59 mL/min/1.73 m2, Group III: 15~44 mL/min/1.73 m2). From collected patient databases, we compared mortality and rate of hospitalization to GFR at 1 month and 12 months follow up. Results: Our study found that, based on the GFR, the 1 year mortality, using the Cockcroft-Gault equation, was 6.0% in group I, 20.3% in group II and 21.1% in group III and, using the MDRD equation, 9.1%, 12.5% and 37.5%, respectively. Patients with lower GFRs exhibited an increased odds ratio for 1 year mortality when estimated by the Cockcroft-Gault equation: 3.97 (1.7~9.2, 95% CI) in group II and 4.16 (1.2~14.5, 95% CI) in group III. Based on the MDRD equation, patients with lower GFRs also exhibited an increased odds ratio for 1-year mortality: 1.43 (0.5~4.4, 95% CI) in group II and 6.00 (1.3~26.8, 95% CI) in group III. The adjusted odds ratio for 1-year mortality also increased based on our analysis using either equation. Conclusions: Decline of GFR and severity of chronic kidney disease are associated with poor clinical outcomes of acute ischemic stroke. (Korean J Med 78:602-609, 2010)
Key Words: Chronic kidney disease; Acute ischemic stroke; Mortality


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