Incidence of Acute Kidney Injury after Stroke and Its Association with 30-day Mortality of Stroke Patients

Abstract

Objective: To investigate the incidence of AKI in stroke patients and its association with 30-day mortality of stroke patients.
Method: This descriptive study was conducted in Medical Unit-I, Holy Family Hospital from June 2020 to January 2021. 130 patients with CT-confirmed stroke (both ischemic and hemorrhagic) with symptoms ranging from 1-24 hours were included in the study using consecutive (non-probability) sampling, after informed consent from theattendants. Patients with a history of recurrent stroke, renal dysfunction before stroke (urea > 52mg/dl and creatinine > 1.2mg/dl, eGFR < 90 ml/min, proteinuria, or patients on dialysis as per medical record), uncontrolled hypertension (BP ≥180/110 mmHg), alcohol use, intravenous drug abuse and diabetes (BSR > 200 mg/dl) were excluded from the study. Patients' baseline serum creatinine levels were recorded and were noted again after 72 hours. A > 0.3 mg/dl increase from the baseline was defined as acute kidney injury. Mortality was recorded in patients who died within 30 days of stroke.
Results: The mean age of the patients was 55.48 ± 10.85 years. 81 patients (62.3%) were male and 49 (37.7%) were female. 25 (19.2%) patients had acute kidney injury. 25 (19.2%) patients (amongst both with and without acute kidney injury) died within 30 days. There was a significant association between acute  kidney injury and 30-day mortality of the stroke patients (p-value<0.001). This association was significant in all age groups, both genders, regardless of present or absent history of smoking and regardless of duration of symptoms prior to arrival (p value <0.001).
Conclusion: Acute kidney injury affects a proportion of patients of stroke. There is a significant association between AKI and 30-day mortality after stroke, suggesting there might be a link between them.