IN HOSPITAL FREQUENCY AND FACTORS RESPONSIBLE FOR ACUTE KIDNEY INJURY AMONG PATIENTS OF ACUTE STROKE: INSIGHTS FROM A TERTIARY CARE SETTING

Abstract

Objective: To determine the in-hospital frequency of acute kidney injury and identify factors associated with its development among patients admitted with acute stroke at a tertiary care hospital. Methods: This was a cross-sectional study of 193 patients between 18-80 years of age with acute ischemic or hemorrhagic stroke admitted within 48 hours of onset of symptoms. Enrolment of the patients was done by non probability consecutive sampling method. Acute kidney injury was defined based on kidney disease: Improving Global Outcomes criteria. Demographic characteristics, comorbidities, type of stroke, National Institutes of Health Stroke Scale (NIHSS) score, Glasgow Coma Scale (GCS) score, hemodynamic instability, dehydration, nephrotoxic drug exposure, contrast exposure, management, length of stay, and mortality were recorded. Independent factors associated with acute kidney injury were determined by using the multivariable binary logistic regression. Results: Of the 193 patients, 64 (33.2%) had acute kidney injury. This happened in 50.0% of patients with hemorrhagic stroke, and 27.3% of those with ischemic stroke. Independent risk factors for acute kidney injury were: hypotension (aOR 3.18); NIHSS score >15 (aOR 2.71); exposure to nephrotoxic medications (aOR 2.52); dehydration (aOR 2.48); hemorrhagic stroke (aOR 2.36); diabetes mellitus (aOR 2.15); and age (aOR 1.04 per year). Acute kidney injury patients had a higher mortality rate (21.9% vs. 6.2%) and longer hospital length of stay (9.8 ± 4.1 vs. 6.2 ± 2.7 days) than did patients without acute kidney injury. Conclusion: Acute kidney injury is a common complication of acute stroke and linked with modifiable and non modifiable clinical variables.