Raffaele Ornello, MD

El Husseini N, Fonarow GC, Smith EE, Ju C, Sheng S, Schwann LH, et al. Association of Kidney Function With 30-Day and 1-Year Poststroke Mortality and Hospital Readmission: Get With The Guidelines-Stroke. Stroke. 2018

Several reports indicate that abnormal kidney function is an important predictor of poor outcome in patients with stroke; however, those previous reports included relatively few patients or did not stratify the outcomes according to the stage of kidney disease.

In the present cohort study of 204,652 patients included in the Get With The Guidelines registry, the authors found a correlation between the estimated glomerular filtration rate and 30-day and 1-year poststroke mortality or hospital readmission, with the poorest prognosis in patients with end-stage kidney disease, after adjusting for demographic characteristics and a wide set of vascular risk factors. Although not considering the impact of acute treatments for ischemic stroke, the data of the present study strongly reaffirm the importance of assessing kidney function to predict ischemic stroke outcomes and suggest the possibility of including the estimated glomerular filtration rate in stroke prognostic models.

Notably, patients with abnormal kidney function had a higher prevalence of vascular risk factors such as previous strokes or TIAs, coronary artery disease, diabetes mellitus, peripheral vascular disease, and heart failure as compared with those with normal function, suggesting that kidney dysfunction identifies a subset of particularly frail stroke patients.