Renal impairment in stroke patients: A comparison between the haemorrhagic and ischemic variants

Shrestha, Pratyush; Thapa, Shalima; Shrestha, Shikher; Lohani, Subash; BK, Suresh; MacCormac, Oscar; Thapa, Lekhjung; Devkota, Upendra Prasad

doi:10.12688/f1000research.12117.2

Cited by 10 publications

(6 citation statements)

References 20 publications

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“…15 Shrestha et al reported higher mean hospital stay in patients with haemorrhagic stroke (14.58±7.19 days) compared to ischaemic stroke (9.86±5.12 days). 12 This study showed that the independent predictor of mortality and morbidity in both types of acute stroke were Age, Hypertension, Diabetes mellitus, Ischaemic heart disease, Dyslipidaemia.…”

Section: Renal Function Assessmentmentioning

confidence: 73%

Serum Creatinine as Predictor Of Outcome in Hospitalized Patients After Acute Stroke

et al. 2023

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Background/Aims: Acute stroke is one of the leading causes of mortality and morbidity worldwide. The adverse outcome following acute stroke depends not only on severity of the neurological defects but also on other co-morbidities. Associated renal impairment has been found to be a major predictor of different outcome following acute stroke in several studies. The aim of this study was to evaluate the impact of the serum creatinine on the outcome of hospitalized patients after acute stroke. Methods: This was a Prospective cohort study conducted on 100 consecutive adult patients who were admitted in the Neurology department of Dhaka Medical College Hospital following acute stroke during January 2018 to December 2019.The patients were followed up for two weeks after the incident stroke. Results: Among the 100 patients with acute stroke 57(57%) were ischaemic and 43(43%) were haemorrhagic stroke. Mean age(SD) was 60.4(10.6) years. Patients with ischaemic stroke were older compared to haemorrhagic stroke (61.1(9.6); 53.8(9.4) years respectively; p<0.05). The mean (SD) serum creatinine on admission in patients with both types of stroke, who deteriorated or died, were significantly higher than in those who survived. Others predictors of mortality and morbidity in both types of acute stroke were age, gender, hypertension, diabetes mellitus, ischemic heart disease, dyslipidaemia. Conclusions: Patients with impaired renal function had worse outcome after hospitalization in both types of acute stroke. Haemorrhagic stroke, older age, high baseline serum creatinine, hypertension were significantly associated with increased mortality and morbidity following acute stroke. Appropriate measures should be taken to patients with impaired renal function to reduce the mortality and morbidity following acute stroke. J Dhaka Med Coll. 2021; 29(1): 16-23

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Section: Renal Function Assessmentmentioning

confidence: 73%

Serum Creatinine as Predictor Of Outcome in Hospitalized Patients After Acute Stroke

et al. 2023

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“…Among the chronic diseases reported in our elderly patients, stroke showed a signi cant association with renal impairment; elderly patients with stroke were 2.5 times more likely to have renal impairment. It's important to note that this is a two-way relationship: while renal impairment is thought to be a predictor of poor clinical outcomes and mortality after stroke, stroke has been found to increase the risk of renal impairment (30,31). This could be because stroke patients have poorer general health and less controlled chronic diseases and thus are predisposed to develop renal impairment (32).…”

Section: Discussionmentioning

confidence: 99%

Polypharmacy associated with renal impairment in elderly people attending primary health care centers

Naghnaghia

Nazzal

Abualia

et al. 2022

Preprint

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Purpose: This study aimed to estimate the prevalence of renal impairment among primary health care (PHC) elderly, its association with polypharmacy, and the most frequent potentially inappropriate prescription (PIP) in renal impairment patients. Methods: A cross-sectional study was conducted among PHC clinic attendees aged 65 and older. We used medical records and an interviewer-administered questionnaire for data collection. Participants with eGFR less than 60mls/min/1.73m2 were categorized as renal impaired; we then calculated the prevalence of renal impairment and used multivariable analysis to identify its predictors. Beer's criteria and literature reviews were used to evaluate renal impairment patients' medication and to determine the frequency of PIPs. Results: The study included 421 participants (224 female, 197 male), and 66.3% were between the ages of 65 and 75. The prevalence of renal impairment was 30.2% (95%CI: 25.8-34.6%). Polypharmacy [aOR= 5.9, 95%CI: 2.4-14.6], stroke [aOR= 2.5, 95%CI: 1.2-5.4], Females [aOR= 2.6, 95%CI: 1.5-4.7], and elderly over the age of 80 [aOR= 4.4, 95%CI: 2.2-8.8] were the main predictors of renal impairment. RAAS (54.3%), metformin (39.3%) and sulfonylurea (20.4%) were the most frequent reported PIP in renal impairment patients. Conclusion: Renal impairment affects nearly one-third of elderly Palestinians who attend PHC clinics and has been strongly linked to polypharmacy in this population. Stroke, age, and gender are other identified risk factors in our study. It is recommended to raise healthcare providers' awareness to control elderly patients’ chronic conditions by cautiously prescribing only necessary medication, choosing non-nephrotoxic alternatives, and monitoring their renal function frequently.

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“…Small sample size and that it only included patients with recognized renal dysfunction could have underestimated the magnitude of renal dysfunction in this study. A prospective cohort study conducted among 52 patients admitted in intensive care unit in Nepal from 2014 to 2015 showed that 48.1% had renal impairment ( 13 ). This outlier discrepancy could be due to significant overestimation of GFR, because direct measurement of Cr clearance to determine renal function is imprecise in critically ill patients due to the increased secretion of Cr in the renal tubules ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Renal Function Abnormalities among Patients with Acute Stroke at a Tertiary Hospital in Ethiopia

Seifu

Gashaye²,

Taye

2022

Ethiop J Health Sci

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BACKGROUND: Stroke is the leading cause of neurological disability and the second commonest cause of death globally. Despite the fact that renal dysfunction is a common comorbidity of stroke, there is no data on the prevalence of renal dysfunction among patients with acute stroke in Ethiopia. The aim of this study was to determine the magnitude of renal dysfunction, factors associated with renal dysfunction and risk of in-hospital mortality. METHODS: A hospital-based cross-sectional study was conducted in Yekatit 12 Hospital Medical College among consecutive 192 patients, who were admitted with acute stroke from September 2020 to September 2021. Data were collected using a structured questionnaire after pilot survey was done. A Multivariate binary logistic regression analysis was fitted to identify determinants of renal function abnormalities. Renal dysfunction was defined as serum creatinine >1.2mg/dl. RESULT: The mean age (SD) of study participants was 62.2 (15.9) years. Hundred-one (52.6%) participants were males. Thirty-four (17.7%) of the participants had renal dysfunction. Among patients with renal dysfunction, more than half of them were ≥70 years old and two-thirds were males. Male gender and hypertension increased the risk of renal dysfunction among hospitalized stroke patients. The mortality rate was higher in stroke patients with renal dysfunction (35.3%) as compared with patients having normal renal function (15.2%), but it was not a statistically significant. CONCLUSION: Renal dysfunction was a frequent comorbidity among acute stroke patients who were hospitalized. Male gender and hypertension were statistically significant predictors of renal dysfunction. Mortality rate was higher in stroke patients with renal dysfunction, but not a statistically significant predictor of post stroke in-hospital mortality.

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Renal impairment in stroke patients: A comparison between the haemorrhagic and ischemic variants

Cited by 10 publications

References 20 publications

Serum Creatinine as Predictor Of Outcome in Hospitalized Patients After Acute Stroke

Serum Creatinine as Predictor Of Outcome in Hospitalized Patients After Acute Stroke

Polypharmacy associated with renal impairment in elderly people attending primary health care centers

Renal Function Abnormalities among Patients with Acute Stroke at a Tertiary Hospital in Ethiopia

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