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. 2013 Sep 13;8(9):e72971.
doi: 10.1371/journal.pone.0072971. eCollection 2013.

Association of renal biomarkers with 3-month and 1-year outcomes among critically ill acute stroke patients

Ying-Chih Huang  1 , Yi-Ling Wu, Ming-Hsueh Lee, Jiann-Der Lee, Chih-Ying Wu, Huan-Lin Hsu, Ya-Hui Lin, Yen-Chu Huang, Wen-Hung Huang, Hsu-Huei Weng, Jen-Tsung Yang, Meng Lee, Bruce Ovbiagele
Affiliations

Association of renal biomarkers with 3-month and 1-year outcomes among critically ill acute stroke patients

Ying-Chih Huang et al. PLoS One. .

Abstract

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) ≥ 30 mg/g] or low estimated glomerular filtration rate (eGFR<60 ml/min per 1.73 m(2)) on stroke patients admitted to the intensive care unit (ICU).

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 <30 mg/g (normal), 30-299 mg/g (microalbuminuria), and ≥ 300 mg/g (macroalbuminuria), while eGFR was divided into ≥ 60, 45-59, and <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.

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.

Conclusions: Presence of macroalbuminuria indicates poor 3-month and 1-year outcomes among critically ill acute stroke patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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