Study: Kidney dysfunction linked to increased mortality after stroke thrombolysis
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Key takeaways:
- Findings showed a link with kidney dysfunction and in-hospital death and neurological scores.
- Age, international normalized ratio and cognitive decline were also tied to neurological scores.
Kidney dysfunction may play a key role in hospital death and the outcome of thrombolysis in patients who have experienced a stroke, according to a recently published study.
“Kidney dysfunction has a tremendous negative impact on the cardiovascular system. ... Chronic kidney disease worsens outcomes of patients with cardiovascular disorders and increases cardiovascular morbidity and mortality,” Dorin Dragos, MD, PhD, of Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and colleagues wrote. “CKD increases stroke risk ... and worsens outcomes,” they wrote.
Researchers of a retrospective cohort observational study collected data from 296 patients who had a stroke and underwent thrombolysis between 2016 and 2020 to determine the importance of CKD among various cardiovascular risk factors that influence the outcome of patients on thrombolytic treatment. The information included an array of risk factors and comorbidities, as well as demographic statistics, lifestyle factors, physical health, lab tests, imaging scans, neurological scores and outcomes.
Of the 296 patients who underwent thrombolysis, 50 died in the hospital. Of the 246 patients discharged, 177 presented for outpatient follow-up and 69 were followed up by phone.
Findings showed a significant relationship between kidney dysfunction, indicated by eGFR, and in-hospital death and neurological scores. Age, international normalized ratio and cognitive decline were also frequently tied to neurological scores, investigators found.
A multivariate analysis, however, revealed eGFR was paramount to determine most of the neurological scores, except for those reflecting patient pre-intervention neurological status.
“This is the first study to report the significance of CKD as a risk factor among stroke patients,” corresponding author Maria Mirabela Manea, MD, PhD, of Carol Davila University of Medicine and Pharmacy, Romania, said in a press release. “Findings hold notable medical significance, which can be used to improve upon current stroke management algorithms.”
Therefore, “our main message to the readers is that renal dysfunction is a key determinant of the outcome of thrombolysed stroke patients,” Dragos said in the study. “This result is bound to have a significant impact on practice; specifically, particular attention should be paid to patients undergoing thrombolysis if they have renal dysfunction, as their outcome may be worse, and they have an increased risk of dying during their hospital stay.”
Reference:
Kidney disease linked to increased mortality after stroke thrombolysis. https://www.wolterskluwer.com/en/news/kidney-disease-linked-to-increased-mortality-after-stroke-thrombolysis#:~:text=Renal%20dysfunction%2C%20especially%20chronic%20kidney%20disease%2C%20is%20the%20biggest%20risk,Lippincott%20portfolio%20by%20Wolters%20Kluwer Published Jan. 2, 2024. Accessed Jan. 30, 2024.
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