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Research Paper | Neurology | Cambodia | Volume 13 Issue 6, June 2024 | Popularity: 5.2 / 10
Renal Function Predicts Outcomes in Ischemic Stroke and Hemorrhagic Stroke
Navuddh Oam, Rina Mey, Veasna Teav, Kimeach Kong, Sem Suos
Abstract: Renal dysfunction has been suggested as risk factor and prognostic factors in cerebrovascular diseases. Regarding the association of renal dysfunction with stroke subtypes, conflicting results have been observed. The aim of this study was to evaluate renal function and the impact of renal function on in-hospital outcomes in hospitalized patients with ischemic and hemorrhagic stroke. We conducted a retrospective cohort study in a sample of 311 hospitalized patients with acute stroke at Department of Neurology, Khmer Soviet Friendship Hospital from January 1, 2020 to June 30, 2021. Mann-Whitney test was used to compare the values of variables between the 2 groups. Multivariate logistic regression was used to identify the independent risk factors for mortality in stroke. In analysis of the impact of severity, variables were standardized for age by arbitrary inclusion of this variable in the model. In addition, for models with a larger number of independent variables, stepwise method was used to eliminate variables (as a criterion for accepting the value of the Wald statistics). Of 311 stroke patients, 52.73% were male and the mean age of 62 years old. There were 84.88% ischemic stroke. The mean serum creatinine on admission in patients with both types of stroke was significantly higher in hemorrhagic stroke. Multivariate analysis showed that independent predictors of severity in patients with ischaemic stroke were: ischemic heart disease or prior myocardial infarction, diabetes, admission glucose and eGFR on admission. Also, multivariate analysis showed that independent predictors of mortality in patients with haemorrhagic stroke were: age and admission glucose. Patients with haemorrhagic stroke, in particular with acute kidney injury during hospitalisation had significantly worse outcomes than patients with ischaemic stroke. Assessment of kidney function is prerequisite to employ the necessary measures to decrease the risk of in-hospital severity among patients with acute stroke. Appropriate approach to patients with renal dysfunction (adequate hydration, avoidance of nephrotoxic drugs, drug dose adjustment etc) should be considered as preventive and therapeutic strategies in the management of acute stroke.
Keywords: Stroke, Chronic Kidney Disease, Cardiovascular Risk, Renal Function, Hospital Outcomes
Edition: Volume 13 Issue 6, June 2024
Pages: 719 - 723
DOI: https://www.doi.org/10.21275/SR24609234755
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