Association between chronic kidney disease and outcomes among admissions for acute ischemic stroke receiving thrombolysis

Abstract

Abstract Background Patients with chronic kidney disease may have hemostatic defects that increase the risk of bleeding following the administration of thrombolysis. Purpose We assessed the association between chronic kidney disease and intracerebral hemorrhage in acute ischemic stroke admissions receiving thrombolysis. Methods Using administrative data from the 2013 and 2014 National Inpatient Sample, adult acute ischemic stroke admissions treated with thrombolysis were identified. Patients with chronic kidney disease were identified via diagnostic coding. We used multivariable logistic regression to estimate the odds of intracerebral hemorrhage in patients with chronic kidney disease after adjustment for age and comorbidities. The association between chronic kidney disease and in-hospital mortality was also evaluated. Results Of 13,993 admissions treated with thrombolysis for acute ischemic stroke, 12.4% (n=1,739) had chronic kidney disease. Intracerebral hemorrhage occurred in 7.6% of patients and 7.0% experienced in hospital mortality. Chronic kidney disease did not increase the odds of intracerebral hemorrhage (odds ratio [OR]=1.00; 95% confidence interval [CI]=0.83–1.20). The adjusted odds of in-hospital mortality were also no different in those with versus without chronic kidney disease (OR=1.19; 95% CI=0.99–1.42). Conclusions Among admissions treated with thrombolysis for acute ischemic stroke, chronic kidney disease was not associated with a higher adjusted odd of intracerebral hemorrhage. Chronic kidney disease did not increase the odds of in-hospital mortality. Funding Acknowledgement Type of funding source: Other. Main funding source(s): SmartState Medication Safety