Effects of low estimated glomerular filtration rate on outcomes after stroke: a hospital‐based stroke registry in C hina

Background and purpose As uncertainty persists over the prognostic significance of low estimated glomerular filtration rate (e GFR ) in acute stroke, the effects of low e GFR on death/disability amongst participants with acute stroke in C hina were determined. Methods Nanjing F irst H ospital stroke registry was a prospective cohort study of stroke patients. Patients with acute stroke (brain infarction, intracerebral hemorrhage or subarachnoid hemorrhage) within 7 days of onset were recruited consecutively from 2004 to 2008. Baseline e GFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Outcomes were death/disability, defined by scores 3–6 on the modified R ankin S cale at 90 days. Results A total of 1909 participants were included in the present analyses. Of them, 112 (5.9%) had baseline moderate to severe decrease in e GFR (G3b‐4) and increasing risk of higher N ational I nstitutes of H ealth S troke S cale ( NIHSS ) scores. Low e GFR was associated with increasing risk of death/disability at 90 days [G3b‐4, odds ratio 2.58 (95% confidence interval 1.71–3.91); G3a, 1.86 (1.35–2.56); G2, 1.21 (0.96–1.52); P trend <0.001). However, the association was not statistically significant after adjustment for demographic and clinical factors including NIHSS scores. Conclusions There were no appreciable effects of low e GFR on death/disability at 90 days independent of other prognostic factors in C hinese patients with acute stroke.