Association of Renal Biomarkers with 3-Month and 1-Year Outcomes among Critically Ill Acute Stroke Patients

作者：Huang Ying Chih; Wu Yi Ling; Lee Ming Hsueh; Lee Jiann Der; Wu Chih Ying; Hsu Huan Lin; Lin Ya Hui; Huang Yen Chu; Huang Wen Hung; Weng Hsu Huei; Yang Jen Tsung; Lee Meng; Ovbiagele Bruce

来源：PLos One, 2013, 8(9): e72971.

DOI：10.1371/journal.pone.0072971

Background: The comparative relationships of widely recognized biomarkers of renal injury with short-term and long-term outcomes among critically ill acute stroke patients are unknown. We evaluated the impact of baseline albuminuria [urine albumin-creatinine ratio (UACR)%26gt;= 30 mg/g] or low estimated glomerular filtration rate (eGFR%26lt;60 ml/min per 1.73 m(2)) on stroke patients admitted to the intensive care unit (ICU). %26lt;br%26gt;Methods: We reviewed data on consecutive stroke patients admitted to a hospital ICU in Taiwan from September 2007 to August 2010 and followed-up for 1 year. Baseline UACR was categorized into %26lt;30 mg/g (normal), 30-299 mg/g (microalbuminuria), and %26gt;= 300 mg/g (macroalbuminuria), while eGFR was divided into %26gt;= 60, 45-59, and %26lt;45 ml/min per 1.73 m(2). The outcome measure was death or disability at 3-month and 1-year after stroke onset, assessed by dichotomizing the modified Rankin Scale at 3-6 versus 0-2. %26lt;br%26gt;Results: Of 184 consecutive patients, 153 (83%) met study entry criteria. Mean age was 67.9 years and median admission NIHSS score was 16. Among the renal biomarkers, only macroalbuminuria was associated with poorer 3-month outcome (OR 8.44, 95% CI 1.38 to 51.74, P = 0.021) and 1-year outcome (OR 18.06, 95% CI 2.59 to 125.94, P = 0.003) after adjustment of relevant covariates. When ischemic and hemorrhagic stroke were analyzed separately, macroalbuminuria was associated with poorer 1-year outcome among ischemic (OR 17.10, 95% CI 1.04 to 280.07, P = 0.047) and hemorrhagic stroke patients (OR 1951.57, 95% CI 1.07 to 3561662.85, P = 0.048), respectively, after adjustment of relevant covariates and hematoma volume. %26lt;br%26gt;Conclusions: Presence of macroalbuminuria indicates poor 3-month and 1-year outcomes among critically ill acute stroke patients.

• 出版日期2013-9-13
• 单位长春大学