Influence of Estimated Glomerular Filtration Rate on Clinical Outcomes in Patients with Acute Ischemic Stroke Not Receiving Reperfusion Therapies

J Clin Med. 2021 Oct 14;10(20):4719. doi: 10.3390/jcm10204719.

Abstract

Background: We aimed to determine whether estimated glomerular filtration rate (eGFR) is an independent predictor of clinical outcomes in patients with acute ischemic stroke not treated with reperfusion therapy.

Methods: A total of 1420 patients with acute ischemic stroke from a hospital-based stroke registry were included in this study. Patients managed with intravenous thrombolysis or endovascular reperfusion therapy were excluded. The included patients were categorized into five groups according to eGFR, as follows: ≥90, 60-89, 45-59, 30-44, and <30 mL/min/1.73 m2. The effects of eGFR on functional outcome at discharge, in-hospital mortality, neurologic deterioration, and hemorrhagic transformation were evaluated using logistic regression analyses.

Results: In univariable logistic regression analysis, reduced eGFR was associated with poor functional outcome at discharge (p < 0.001) and in-hospital mortality (p = 0.001), but not with neurologic deterioration and hemorrhagic transformation. However, no significant associations were observed between eGFR and any clinical outcomes in multivariable analysis after adjusting for clinical and laboratory variables.

Conclusions: Reduced eGFR was associated with poor functional outcomes at discharge and in-hospital mortality but was not an independent predictor of short-term clinical outcomes in patients with acute ischemic stroke who did not undergo reperfusion therapy.

Keywords: chronic kidney disease; clinical outcome; estimated glomerular filtration rate; ischemic stroke.