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Kidney Function and Post-Stroke Mortality Examined

Stroke; ePub 2018 Nov 9; El Husseini, Fonarow, et al

Within the first year after index hospitalization for ischemic stroke, estimated glomerular filtration rate (eGFR) and dialysis status on admission are associated with post-stroke mortality and hospital readmissions, a recent study found. Therefore, it is suggested that kidney function should be included in risk-stratification models for post-stroke outcomes. In this cohort study of fee-for-service Medicare patients admitted with ischemic stroke admitted to hospitals between 2009 and 2014, adjusted multivariable Cox proportional hazards models were used to determine the independent associations of eGFR and dialysis status with 30-day and 1-year post-discharge mortality and re-hospitalizations. Researchers found:

  • Of 204,652 patients discharged alive, 48.8% had an eGFR ≥60, 26.5% an eGFR 45 to 59, 16.3% an eGFR 30 to 44, 5.1% an eGFR 15 to 29, 0.6% an eGFR <15 without dialysis, and 2.8% were receiving dialysis.
  • Compared with eGFR ≥60, and after adjusting for relevant variables, eGFR <45 was associated with increased 30-day mortality with the risk highest among those with eGFR <15 without dialysis (hazard ratio [HR], 2.09).
  • An eGFR <60 was associated with increased 1-year post-stroke mortality that was highest among patients on dialysis (HR, 2.65).

El Husseini N, Fonarow GC, Smith EE, et al. Association of kidney function with 30-day and 1-year poststroke mortality and hospital readmission. [Published online ahead of print November 9, 2018]. Stroke. doi:10.1161/STROKEAHA.118.022011.