Acute Kidney Injury in Patients with Acute Stroke

Abstract

BACKGROUND:According to world health organization, about 15 million people suffer from stroke worldwide eachyear. Acute kidney injury complicates 5-7% of acute care hospital admissions and up to 30% ofcritical care patients. These in turn lead to increase disability, decreased quality of life anddisproportionate burden on healthcare resources. Patients admitted for diagnosis and treatmentof acute stroke are at high risk of developing acute kidney injury due to comorbid conditions, poororal intake and exposure to nephrotoxic agents.OBJECTIVE:to determine the incidence of acute kidney injury in patients admitted with acute stroke andevaluates 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 ischemicstroke 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 7days after onset of stroke, KDIGO criteria was used to define patients who developed acute kidneyinjury which include elevation of serum creatinine of 0.3 mgdl or more within 48 hours or 1.5 foldor more increment of baseline serum creatinine within 7 days.RESULTS:Acute kidney injury was a common complication in acute stroke population with total incidence13.5%, with significantly higher incidence in intracerebral hemorrhage group (22.9%) than inischemic group (10.4%) p=0.000919. The study also show significant sex difference with higherincidence in males than females in ischemic group (13.4% vs 6.7%; p= 0.049) intracerebralhemorrhage group (31.5% vs 12.3%; p=0.0246).Study also shows significant relation between developing acute kidney injury and history ofhypertension in both groups with p=0.00229, and significant relation with diabetes mellitusp=0.009096.Study shows that there is significant elevation of serum creatinine on consecutive measures betweenfirst day and day 7 with p=0.000.We found that there is significant direct relation between increasing age and incidence of acutekidney injury with p=0.040 in ischemic group and p= 0.015 in intracerebral hemorrhage group.CONCLUSION:The incidence of acute kidney injury in acute stroke patients was 13.5% with significantly higherincidence in intracerebral hemorrhage group with significant relation between development of acutekidney injury and being male, has hypertension, diabetes mellitus or advance age.