Study of microalbuminuria in acute ischemic stroke and its correlation with severity

Abstract

Introduction: With the rising incidence of noncommunicable diseases such as stroke in low- and medium-income countries like India, it has become imperative to identify the potentially modifiable risk factors and focus on prevention. Microalbuminuria (MA) is now gaining recognition as an independent risk factor for ischemic stroke. It has also been studied as a prognostic marker for acute ischemic stroke. Thus, it was intended to study MA in acute ischemic stroke and its correlation with stroke severity. Methods: A single-center case–control study was done after enrolling seventy cases of ischemic stroke with age between 40 and 65 years, satisfying inclusion and exclusion criteria during a span of 2 years. Fifty patients in the age group of 40–65 years with no history of stroke and transient ischemic attack and fulfilling the exclusion criteria were taken as control. All cases were subjected to detailed history, systemic clinical examination, and biochemical and radiological investigations with assessment of National Institutes of Health Stroke Scale (NIHSS) for grading of severity of ischemic stroke with semi-quantitative measurement of MA (urinary albumin: creatinine ratio). Results: Hypertension (62.86%), diabetes mellitus (34.29%), and smoking (27.14%) were found to be the major risk factors for acute ischemic stroke. MA was present in 48.57% of cases, whereas in the control group, MA was present only in 18% of patients. Our study showed MA as an independent risk factor for acute ischemic stroke. On multivariate logistic regression analysis of risk factors of acute ischemic stroke, odd ratio for MA was 4.312 with P = 0.005. In our study, cases with mean NIHSS 17.71 and median NIHSS 18 were positive for MA, while cases with mean NIHSS 13.03 and median NIHSS 12 were negative for MA, that is, cases with higher mean and median NIHSS were positive for MA. This association of MA with NIHSS was statistically significant (P = 0.036). Conclusion: MA was found in approximately half of the patients studied with acute ischemic stroke, and there was a significant association between MA and higher NIHSS.