Abstract 17379: Prevalence and Significance of Unrecognized Renal Dysfunction in Patients With Stroke
Introduction: Unrecognized renal dysfunction, defined as estimated glomerular filtration rate <60ml/min1.73m2 in the presence of normal serum creatinine levels, is a common co-morbidity among patients with various cardiovascular conditions. The current study was aimed to evaluate the prevalence and clinical significance of unrecognized renal dysfunction in patients with acute stroke.
Methods: The cohort consisted of patients with acute stroke included in the prospective National Acute Stroke ISraeli (NASIS) registry. Unrecognized renal insufficiency was defined as estimated glomerular filtration rate <60 ml/min/1/73 m2 in the presence of serum creatinine ≤1.2mg/dl. The two primary outcomes were in-hospital mortality and the composite of in-hospital mortality or severe disability at hospital discharge.
Results: Of the 7900 stroke patients included in the study, 5571 (70.5%) patients had normal renal function, 1510 (19.1%) had recognized renal insufficiency and 819 (10.4%) had unrecognized renal insufficiency. Mortality rates were higher in patients with recognized and unrecognized renal insufficiency compared to patients with normal renal function (9.9%, 9.1% and 4.4% respectively, p<0.0001). Adjusted odds ratios for in-hospital mortality were higher for patients with renal dysfunction either recognized (OR= 2.1, 95%CI=1.6-2.7, P<0.001) or unrecognized (OR=1.6, 95%CI=1.1-2.2, P=0.006) compared to patients with normal renal function. Similarly, adjusted odds ratios for the composite of in-hospital mortality or severe disability at hospital discharge were higher for patients with renal dysfunction either recognized (OR= 1.3, 95%CI=1.1-1.5, P=0.004) or unrecognized (OR=1.2, 95%CI=1.01-1.5, P=0.04).
Conclusions: Unrecognized renal insufficiency is common among patients with acute stroke and is associated with adverse short-term outcomes.
Author Disclosures: D. Pereg: None. Z. Rozenbaum: None. D. Vorobeichik: None. D. Tanne: None.
- © 2016 by American Heart Association, Inc.