Estimated glomerular filtration rate decline in 567 patients with acute stroke.

Objective: Chronic kidney disease, characterized by a decline in renal function, is a public health challenge, affecting around 10% of the population worldwide. The aim of this study was to investigate the prevalence of decline in renal function in patients admitted for acute first-ever stroke from a local centre in China, and its impact on mortality and neurological impairment during a short follow-up period.

Material and methods: In total, 640 patients hospitalized due to acute stroke were enrolled in this prospective study. Clinical data were obtained and a 3-month follow-up was executed by a team of trained investigators. The data indicated that the prevalence of estimated glomerular filtration rate (eGFR) decline (≤60 ml/min/1.73 m(2)) was 18.5% in this specific population.

Results: Hyperuricaemia, elevated homocysteine and smoking history were identified as three major risk factors associated with eGFR decline. An eGFR ≤60 ml/min/1.73 m(2) was detected in 45.1% of haemorrhagic stroke patients, while 14.7% of ischaemic stroke patients had an accompanying eGFR decline. During the follow-up period, the mortality rate was 18.1% in patients with eGFR decline and 1.5% in patients with eGFR >60 ml/min/1.73 m(2).

Conclusions: This study clearly shows that the prevalence of renal impairment is high in acute stroke patients in China, and renal impairment may confer a significant risk for worse outcomes such as impaired neurological function and death, at least in the short term.