Kidney dysfunction at the time of intracerebral hemorrhage is associated with increased in-hospital mortality: a retrospective observational cohort study

Abstract

Objective: Renal dysfunction has been implicated as a risk factor for adverse outcomes after numerous cardiovascular events including stroke. However, most of the stroke studies have focused on long-term results and have primarily examined ischemic stroke. Therefore, we aimed to determine if renal dysfunction was associated with increased initial in-hospital mortality after intracerbral hemorrhage (ICH).Methods: Our retrospective, observational, cohort chart review evaluated the relationship between in-hospital mortality after ICH and renal function, assessed from admission estimated glomerular filtration rate (eGFR), calculated using the abbreviated modification of diet in renal disease equation, in 101 consecutive cases.Results: Survivors had higher admission eGFRs than those who died (88±37 versus 59±33 ml/minute/1·73 m2; P<0·001). Similarly, mortality was higher in patients with eGFR <90 versus those >90 ml/minute/1·73 m2 (40% versus 15%; P = 0·009). Univariate analysis indicated that in-hospital death was associated with intraventricular hemorrhage, ICH volume, age, eGFR <90 ml/minute/1·73 m2, and admission values of serum creatinine, and blood urea nitrogen (P<0·05). Multivariable logistic regression (controlled for confounding variables) revealed that admission eGFR was an independent predictor of death; odds ratio 0·96; 95% confidence interval 0·92–0·99. We also found a negative correlation between eGFR and lesion size (P = 0·041); the lower the eGFR, the larger the lesion.Conclusion: Renal dysfunction was an independent predictor of initial in-hospital mortality after stroke and hence may stratify risk in ICH patients.