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Chronic Kidney Disease and Clinical Outcomes in Patients with Intracerebral Hemorrhage.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Aug; Vol. 29 (8), pp. 104802. Date of Electronic Publication: 2020 Apr 25. - Publication Year :
- 2020
-
Abstract
- Background and Purpose: The influence of chronic kidney disease (CKD) on functional outcome in intracerebral hemorrhage (ICH) is scarcely investigated and reported findings are conflicting mostly because of nonaccounting for imbalances. Aim of the present study was to determine the impact of CKD on functional long-term outcome in ICH-patients.<br />Methods: In this observational cohort study of spontaneous ICH-patients admitted to our Department of Neurology between 2006 and 2015 we investigated retrospectively as primary outcome the dichotomized functional status (modified-Rankin-Scale = 0-3-versus-4-6) at 12 months according to renal function (CKD versus non-CKD), including categorial estimates of the glomerular filtration rate subanalyses. Confounding was addressed by propensity-score(ps)-matching and adjusted multivariable regression analyses.<br />Results: We identified 1076 eligible ICH-patients, of which 131 (12.2%) suffered from CKD on hospital admission. Confounders associated with CKD consisted of hypertension (P = .023), Diabetes mellitus (P = .001), prior ischemic stroke and/or transitory ischemic attack (TIA) (P = .021), congestive heart failure (P < .01), impaired liver function (P < .01), antiplatelet therapy (P = .01), poorer premorbid functional status (P < .01), and deep ICH-location (P = .006). After balancing for confounding, patients with CKD showed a significantly decreased rate of favorable functional outcome at 12 months (CKD:29 of 111(26.1%)-versus-non-CKD:78 of 206 (37.9%); P = .035). Subanalyses showed that stages of CKD were evenly associated with mortality at 12 months (GFR category G3a, OR:2.811; CI (1.130-6.994); P = .026; GFR category G3b, OR:1.874; CI (.694-5.058); P = .215; GFR category G4, OR:10.316; CI (1.976-53.856); P = .006; GFR category G5, OR:8.989; CI (1.900-42.518); P = .006).<br />Conclusions: As compared to ICH-patients without CKD, those with CKD show increased rates of mortality and worse functional outcomes even after statistical correction for imbalanced baseline characteritsics. This finding is presumably linked to comorbidity and warrants further investigation in prospective studies.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Cerebral Hemorrhage diagnostic imaging
Cerebral Hemorrhage mortality
Cerebral Hemorrhage therapy
Disability Evaluation
Female
Germany
Humans
Male
Middle Aged
Prognosis
Recovery of Function
Renal Insufficiency, Chronic diagnosis
Renal Insufficiency, Chronic mortality
Renal Insufficiency, Chronic therapy
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Cerebral Hemorrhage physiopathology
Glomerular Filtration Rate
Kidney physiopathology
Renal Insufficiency, Chronic physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 29
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 32689604
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104802