入院时肾功能异常预示着卒中患者更高的死亡率。

IF 1.3
Mohammad A Mekhlafi, Bashair M Ibrahim, Lama A Rayyis
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引用次数: 2

摘要

目的:探讨肾功能异常对脑卒中转归的影响。方法:对2010年至2014年沙特阿拉伯阿卜杜勒阿齐兹国王大学医院收治的脑卒中患者进行回顾性队列研究。入院时采集血清肌酐和尿蛋白。我们将蛋白尿定义为尿蛋白试纸>/=+1。估计肾小球滤过率(eGFR)由肾脏疾病饮食修正研究方程计算,单位为mL/min/1.73m2。异常肾脏疾病定义为肌酐>126 mg/dl或egfr。结果:548例患者中,507例患者入院时有肌酐测量,193例患者肾功能异常。这些患者往往年龄较大(中位年龄为67岁,肾功能正常者为60.5岁)、男性(66.7%对54.3%)和高血压(96%对88%)。两组间糖尿病患病率无差异。蛋白尿与未来死亡率无关。肾功能异常是卒中后1年死亡率的重要预测因子(校正OR=2.5, 95% CI=1.4 ~ 4.6;假定值= 0.003)。结论:在我们的队列中,肾功能异常使卒中后一年死亡的风险增加了一倍。高风险人群,包括老年高血压男性,可以成为积极监测和早期治疗危险因素的目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abnormal admission kidney function predicts higher mortality in stroke patients.

Objective: To investigate the impact of abnormal kidney function on stroke outcome.

Methods: This was a retrospective cohort of stroke patients admitted to King Abdulaziz University Hospital in Kingdom of Saudi Arabia between 2010 and 2014. Serum creatinine and urine protein were collected at admis-sion. We defined proteinuria as urine protein dipstick >/=+1. Estimated glomerular filtration (eGFR) rate was calculated by Modification of Diet in Renal Disease Study equation in mL/min/1.73m2. Abnormal kidney disease was defined as Creatinine>126 mg/dl or eGFR<60. Clinical characteristics and outcomes including one-year mortality and 30-day readmission were compared between patients with versus (vs.) without abnormal kidney function and/or proteinuria.

Results: Out of 548 patients, 507 had creatinine measurement at admission and 193 patients had ab-normal kidney function. These patients tended to be older (median age 67 years vs. 60.5 for those with normal kidney function), men (66.7% vs. 54.3%), and hypertensive (96% vs. 88%). Diabetes prevalence did not differ between the 2 groups. Proteinuria was not associ-ated with future mortality. Abnormal kidney function was a significant predictor of post-stroke one-year mortality (adjusted OR=2.5, 95% CI=1.4 to 4.6; p-value=0.003).

Conclusion: Abnormal kidney function doubled the risk of one-year mortality post stroke in our cohort. High-risk groups, including older hypertensive men, could be targeted for aggressive moni-toring and early treatment of risk factors.

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