Cargando…
Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke
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...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025354/ https://www.ncbi.nlm.nih.gov/pubmed/32082552 http://dx.doi.org/10.1093/ckj/sfz049 |
_version_ | 1783498499847880704 |
---|---|
author | Arnold, Julia Sims, Don Gill, Paramjit Cockwell, Paul Ferro, Charles |
author_facet | Arnold, Julia Sims, Don Gill, Paramjit Cockwell, Paul Ferro, Charles |
author_sort | Arnold, Julia |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7025354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-70253542020-02-20 Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke Arnold, Julia Sims, Don Gill, Paramjit Cockwell, Paul Ferro, Charles Clin Kidney J AKI 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. Oxford University Press 2019-05-10 /pmc/articles/PMC7025354/ /pubmed/32082552 http://dx.doi.org/10.1093/ckj/sfz049 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | AKI Arnold, Julia Sims, Don Gill, Paramjit Cockwell, Paul Ferro, Charles Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
title | Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
title_full | Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
title_fullStr | Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
title_full_unstemmed | Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
title_short | Acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
title_sort | acute kidney injury calculated using admission serum creatinine underestimates 30-day and 1-year mortality after acute stroke |
topic | AKI |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025354/ https://www.ncbi.nlm.nih.gov/pubmed/32082552 http://dx.doi.org/10.1093/ckj/sfz049 |
work_keys_str_mv | AT arnoldjulia acutekidneyinjurycalculatedusingadmissionserumcreatinineunderestimates30dayand1yearmortalityafteracutestroke AT simsdon acutekidneyinjurycalculatedusingadmissionserumcreatinineunderestimates30dayand1yearmortalityafteracutestroke AT gillparamjit acutekidneyinjurycalculatedusingadmissionserumcreatinineunderestimates30dayand1yearmortalityafteracutestroke AT cockwellpaul acutekidneyinjurycalculatedusingadmissionserumcreatinineunderestimates30dayand1yearmortalityafteracutestroke AT ferrocharles acutekidneyinjurycalculatedusingadmissionserumcreatinineunderestimates30dayand1yearmortalityafteracutestroke |