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Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke.

ABSTRACT: Background:Acute kidney injury (AKI) diagnosis requires ascertainment of change from a known baseline. Although pre-admission serum creatinine (SCr) is recommended, to date, all studies of AKI in acute stroke have used the first SCr on admission. Methods:All patients admitted with an acute stroke to an emergency hospital were recruited. We compared use of pre-admission SCr with admission SCr to diagnose AKI. Regression analyses were used to identify risk factors for 30-day and 1-year mortality, respectively. Results:A total of 1354 patients were recruited from December 2012 to September 2015. Incidence of AKI was 18.7 and 19.9% using pre-admission SCr and admission SCr, respectively. Diagnosis of AKI was associated with significantly increased 30-day and 1-year mortality. Diagnosis of AKI using pre-admission SCr had a stronger relationship with both 30-day and 1-year mortality. In 443 patients with a pre-admission SCr and at least two SCr during admission, AKI diagnosed using pre-admission SCr had a stronger relationship than AKI diagnosed using admission SCr with 30-day mortality [odds ratio (OR) = 2.64; 95% confidence interval (CI) 1.36-5.12; P = 0.004 versus OR = 2.10; 95% CI 1.09-4.03; P = 0.026] and 1-year mortality [hazard ratio (HR) = 1.90, 95% CI 1.32-2.76; P = 0.001 versus HR = 1.47; 95% CI 1.01-2.15; P = 0.046] in fully adjusted models. Conclusions:AKI after stroke is common and is associated with increased 30-day and 1-year mortality. Using first SCr on admission gives a comparable AKI incidence to pre-admission SCr, but underestimates 30-day and 1-year mortality risk.

SUBMITTER: Arnold J

PROVIDER: S-EPMC7025354 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke.

Arnold Julia J Sims Don D Gill Paramjit P Cockwell Paul P Ferro Charles C

Clinical kidney journal 20190510 1

<h4>Background</h4>Acute kidney injury (AKI) diagnosis requires ascertainment of change from a known baseline. Although pre-admission serum creatinine (SCr) is recommended, to date, all studies of AKI in acute stroke have used the first SCr on admission.<h4>Methods</h4>All patients admitted with an acute stroke to an emergency hospital were recruited. We compared use of pre-admission SCr with admission SCr to diagnose AKI. Regression analyses were used to identify risk factors for 30-day and 1-y ...[more]

PMID: 32082552

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Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke.

Publications

Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke.

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