Acute kidney injury increases mortality in acute stroke. A study in Hispanic population

Abstract

Acute Kidney Injury (AKI) in stroke is associated with mortality that is estimated on 25% of stroke patients. Prognosis mainly depends on glomerular filtration rate (GFR), comorbidities(diabetes, arterial hypertension, atrial fibrillation and heart failure), evolution time, location, stroke type, hemorrhagic conversion, gender and age. Document prevalence and risk factors involved in the development of AKI in Hispanic cohort of stroke patients. One hundred patients with stroke admitted to the stroke unit during September 2012 to 2018 were included. AKI was established according to the guidelines KDIGO2012. Creatinine and diuresis were evaluated during the first week after the diagnosis of acute stroke. The mean age was 65.15 years (SD 15.91), 55% male and 83% of patients with ischemic stroke. The mean baseline GFR was 73.88 ml/min/1.73 m2. At admission 59% were in the category of basal GFR G2 and G3a (40–89 ml/min/ 1.73 m2). AKI was diagnosed in 54 patients (54%) most of them started 2.5 days after STROKE. In the present series, 10% of stroke patients died, 90% of them having AKI, exist association between AKI and mortality was observed (Fisher exact test p = 0.019). The analysis among risk factors and development of AKI after acute stroke showed association between glycemic variability with development of AKI (bivariate analysis with Fisher exact test p = 0.0001, OR 4.8, 95 % CI 1.79 – 13.08). The patient with AKI + STROKE is 9 times more likely to die during the hospitalization. Strict control of blood glucose, and early detection and treatment of AKI will influence mortality in the first week post STROKE.