Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

BACKGROUND AND OBJECTIVES: Acute kidney injury (AKI) has been associated with increased mortality in a variety of clinical settings. We studied the incidence, predictors, and effect of AKI on long-term overall mortality and cardiovascular events after stroke. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a prospective outcome study of 2155 patients who sustained an acute first-ever stroke and were followed for 10 yr. Patients were divided in two groups: (1) Those with an acute increase (over 48 h) in serum creatinine >or=0.3 mg/dl or a percentage increase of >or=50% and (2) those with a change <0.3 mg/dl, no change at all, or even a reduction. RESULTS: Twenty-seven percent of patients developed AKI after acute stroke. Stroke severity, baseline estimated GFR, heart failure, and stroke subtype predict the occurrence of AKI. The probability of 10-yr mortality for patients with AKI was 75.9 and 57.7 in the patients without AKI (log rank test 45.0; P = 0.001). When patients with AKI were subdivided into three groups according to AKI severity, the probability of 10-yr mortality increased: 73.7, 86.5, and 89.2 in stages 1, 2, and 3, respectively. In Cox proportional hazard analysis, AKI was an independent predictor of 10-yr mortality (P < 0.01) and for the occurrence of new composite cardiovascular events (P < 0.05) after adjustment for available confounding variables. CONCLUSIONS: AKI after stroke is a powerful and independent predictor of 10-yr mortality and new composite cardiovascular events.

Original publication

DOI

10.2215/CJN.04110808

Type

Journal article

Journal

Clin J Am Soc Nephrol

Publication Date

03/2009

Volume

4

Pages

616 - 622

Keywords

Acute Disease, Aged, Aged, 80 and over, Biomarkers, Cardiovascular Diseases, Creatinine, Female, Glomerular Filtration Rate, Heart Failure, Humans, Incidence, Kaplan-Meier Estimate, Kidney Diseases, Male, Middle Aged, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Stroke, Time Factors