Estimated Glomerular Filtration Rate (eGFR) as a Predictor of 1-Month Clinical Outcome in First-Ever Acute Ischemic Stroke Patients

Billi; Muhammad Akbar; David Gunawan Umbas; Firdaus Hamid; Andi Kurnia Bintang; Mimi Lotisna

doi:10.47353/jsocmed.v2i12.110

Estimated Glomerular Filtration Rate (eGFR) as a Predictor of 1-Month Clinical Outcome in First-Ever Acute Ischemic Stroke Patients

Billi
Neurology Resident in Medical Faculty, Hasanuddin University, Makassar, Indonesia.
Muhammad Akbar
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
David Gunawan Umbas
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Firdaus Hamid
Teaching Staff, Consultant Microbiologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia.
Andi Kurnia Bintang
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Mimi Lotisna
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia

Abstract

Introduction: Renal dysfunction is a new risk factor that is thought to influence the clinical outcome of acute ischemic stroke. In this case, the estimated glomerular filtration rate (eGFR) value is used as an approach to assess kidney function status in acute ischemic stroke patients. This study aims to find the relationship between eGFR and clinical outcomes of acute ischemic stroke.

Method: 70 samples were obtained according to inclusion criteria. eGFR is calculated within first week of stroke onset using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. A normality test was carried out on the data, then determined the correlation and compared eGFR with good [modified Rankin Scale (mRS) 0-2] and poor (mRS 3-6) clinical outcomes on the 30th day.

Results: In this study, the average age of the sample was 61.37 years. The largest population was in the 45-59 mL/min/1.73 m2 eGFR group (38,6%). The mean eGFR (p<0.001) for all samples, good, and bad outcome groups was respectively 59.90 ± 21.09, 79.79 ± 19.21, and 52.49 ± 16.57. In this study the poor outcome group had a lower mean eGFR than the good outcome group (52.49 mL/min/1.73 m2 vs 79.79 mL/min/1.73 m2), with a cut-off value of 62 mL/min/1.73 m2 (sensitivity 80.39%, specificity 84.21%) tended to have worse clinical outcomes.

Conclusion: Based on the results of this study, eGFR has a relationship with clinical outcomes (p<0.001) and can objectively predict clinical outcomes on the 30th day of acute ischemic stroke.

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Published at

31. December 2023
https://doi.org/10.47353/jsocmed.v2i12.110
Issue:

Vol. 2 No. 12 (2023): December
Section:

Articles
Keywords:

Stroke Chronic Kidney Disease Epidemiology Collaboration CKD-EPI Modified Rankin Scale (mRS) Estimated glomerular filtration rate (eGFR)
References:

Murphy SJ, Werring DJ. Stroke: causes and clinical features. Medicine. 2020; 48(9): 561–566.

Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A. et al. Council on Nutrition, Physical Activity and Metabolism (2013). An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(7): 2064–2089.

Chwojnicki K, Król E, Wierucki Ł, Kozera G, Sobolewski P, Nyka WM. et al. Renal Dysfunction in Post-Stroke Patients. PloS one. 2016; 11(8): e0159775.

Zhao Q, Yan T, Chopp M, Venkat P, Chen J. Brain-kidney interaction: Renal dysfunction following ischemic stroke. Journal of cerebral blood flow and metabolism. 2020; 40(2): 246–262.

Liu M, Liang Y, Chigurupati S, Lathia JD, Pletnikov M, Sun Z. et al. Acute kidney injury leads to inflammation and functional changes in the brain. Journal of the American Society of Nephrology. 2008; 19(7): 1360–1370.

Widhi Nugroho A, Arima H, Miyazawa I, Fujii T, Miyamatsu N, Sugimoto Y. et al. The Association between Glomerular Filtration Rate Estimated on Admission and Acute Stroke Outcome: The Shiga Stroke Registry. Journal of atherosclerosis and thrombosis. 2018; 25(7): 570–579.

Eun MY, Park JW, Cho BH, Cho KH, Yu S. Influence of Estimated Glomerular Filtration Rate on Clinical Outcomes in Patients with Acute Ischemic Stroke Not Receiving Reperfusion Therapies. Journal of clinical medicine. 2021; 10 (20): 4719.

Wang X, Wang Y, Wang C, Zhao X, Xian Y, Wang D. et al. Association between estimated glomerular filtration rate and clinical outcomes in patients with acute ischaemic stroke: results from China National Stroke Registry. Age and ageing. 2014; 43(6): 839–845.

Lu S, Robyak K, Zhu Y. The CKD-EPI 2021 Equation and Other Creatinine-Based Race-Independent eGFR Equations in Chronic Kidney Disease Diagnosis and Staging. The journal of applied laboratory medicine. 2023; 8(5): 952–961.

Cusumano AM, Tzanno-Martins C, Rosa-Diez GJ. The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool. Frontiers in medicine. 2021; 8: 769335.

Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI. et al. CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration): A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009; 150 (9): 604-12.

Mihardja L, Delima D, Massie RGA, Karyana M, Nugroho P, Yunir E. Prevalence of kidney dysfunction in diabetes mellitus and associated risk factors among productive age Indonesian. J Diabetes Metab Disord. 2018; 17 (1): 53-61.

Wang X, Luo Y, Wang Y, Wang C, Zhao X, Wang D. et al. Comparison of associations of outcomes after stroke with estimated GFR using Chinese modifications of the MDRD study and CKD-EPI creatinine equations: results from the China National Stroke Registry. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2014; 63(1): 59–67.

Wang IK, Liu CH, Yen TH, Jeng JS, Sung SF, Huang PH. et al. Renal function is associated with 1-month and 1-year mortality in patients with ischemic stroke. Atherosclerosis. 2018; 269: 288–293.

Miwa K, Koga M, Nakai M, Yoshimura S, Sasahara Y, Koge J. et al. Etiology and Outcome of Ischemic Stroke in Patients With Renal Impairment Including Chronic Kidney Disease: Japan Stroke Data Bank. Neurology. 2022; 98 (17): e1738–e1747.

Khatri M, Himmelfarb J, Adams D, Becker K, Longstreth WT, Tirschwell DL. Acute kidney injury is associated with increased hospital mortality after stroke. Journal of stroke and cerebrovascular diseases. 2014; 23(1), 25–30.

Shrestha P, Thapa S, Shrestha S. Renal impairment in stroke patients: A comparison between the haemorrhagic and ischemic variants. F1000Research. 2017, 6: 1531.

Castro P, Azevedo E, Rocha I, Sorond F, Serrador JM. Chronic kidney disease and poor outcomes in ischemic stroke: is impaired cerebral autoregulation the missing link?. BMC neurology. 2018; 18(1): 21.

Arnold J, Ng KP, Sims D, Gill P, Cockwell P, Ferro C. Incidence and impact on outcomes of acute kidney injury after a stroke: a systematic review and meta-analysis. BMC Nephrol. 2018; 19(1): 283.

Delgado Acosta F, Jiménez Gómez E, Bravo Rey I, Valverde Moyano R, de Asís Bravo-Rodriguez F, Oteros Fernández R. Contrast-induced nephropathy: A dilemma between loss of neurons or nephrons in the setting of endovascular treatment of acute ischemic stroke. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences. 2020; 26(1): 33–37.

Chusiri S, Chutinet A, Suwanwela NC, Puttilerpong C. Incidence and Risk Factors of Postcontrast Acute Kidney Injury in Patients with Acute Ischemic Stroke. Stroke research and treatment. 2020; 2020: 7182826.

Diprose WK, Sutherland LJ, Wang MTM, Barber PA. Contrast-Associated Acute Kidney Injury in Endovascular Thrombectomy Patients With and Without Baseline Renal Impairment. Stroke. 2019; 50 (12): 3527–3531.

Rachoin JS, Wolfe Y, Patel S, Cerceo E. Contrast associated nephropathy after intravenous administration: what is the magnitude of the problem?. Renal failure. 2021; 43 (1): 1311–1321.

Laville SM, Lambert O, Hamroun A, Metzger M, Jacquelinet C, Laville M. et al. Consequences of oral antithrombotic use in patients with chronic kidney disease. Clinical and translational science. 2021; 14(6): 2242–2253.

Kim SY, Moon A. Drug-induced nephrotoxicity and its biomarkers. Biomolecules & therapeutics. 2012; 20 (3): 268–272.

Ghane Shahrbaf F, Assadi F. Drug-induced renal disorders. Journal of renal injury prevention. 2015; 4(3): 57–60.

Ingrasciotta Y, Sultana J, Giorgianni F, Caputi AP, Arcoraci V, Tari DU. et al. The burden of nephrotoxic drug prescriptions in patients with chronic kidney disease: a retrospective population-based study in Southern Italy. PloS one. 2014; 9 (2): e89072.

Liu H, Zheng H, Wu P, Liu CF, Wang D, Li H. et al. Estimated glomerular filtration rate, anemia and outcomes in patients with ischemic stroke. Annals of translational medicine. 2020; 8(1): 2.

Yao Z, Xu H, Cheng Y, Xu Y. Relationship between estimated glomerular filtration rate and outcome of ischemic stroke patients after mechanical thrombectomy. CNS neuroscience & therapeutics. 2021; 27(11): 1281–1288.

Chao CH, Wu CL, Huang WY. Association between estimated glomerular filtration rate and clinical outcomes in ischemic stroke patients with high-grade carotid artery stenosis. BMC neurology. 2021; 21(1): 124.

He P, Li H, Zhang Z, Zhang Y, Lin T, Song Y. et al. Change in the Estimated Glomerular Filtration Rate Over Time and Risk of First Stroke in Hypertensive Patients. Journal of epidemiology. 2023; 33 (3):142-9.

Lin S, Luan X, He W, Ruan Y, Yuan C, Fan A. et al. Post-Stroke Depression and Estimated Glomerular Filtration Rate: A Prospective Stroke Cohort. Neuropsychiatric disease and treatment. 2020; 16: 201–208.

Li Z, Li Z, Zhou Q, Gu H, Wang Y, Zhao X, Chinese Stroke Center Alliance investigators. Effects of estimated glomerular filtration rate on clinical outcomes in patients with intracerebral hemorrhage. BMC neurology. 2022; 22(1): 19.
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Billi, Akbar, M., David Gunawan Umbas, Hamid, F., Bintang, A. K., & Lotisna, M. (2023). Estimated Glomerular Filtration Rate (eGFR) as a Predictor of 1-Month Clinical Outcome in First-Ever Acute Ischemic Stroke Patients. Journal of Society Medicine, 2(12), 408–416. https://doi.org/10.47353/jsocmed.v2i12.110