title: Intravenous rt-PA in patients with ischaemic stroke and renal dysfunction.
abstract: OBJECTIVE
  Renal dysfunction (RD) increases risk for ischaemic stroke (IS). The impact of RD on the effects of iv-thrombolysis in the Caucasian population has not been fully determined.
  
  
  OBJECTIVE
  To evaluate the associations between RD and the outcome of iv-thrombolysis in Caucasian patients with IS.
  
  
  METHODS
  The observational, multicentre study included 404 patients with IS who were treated with iv-thrombolysis. RD was defined as estimated glomerular filtration rate ≤ 60 ml/min/1.73 m(2). Outcome was assessed with modified Rankin Score at 3 months after the stroke onset.
  
  
  RESULTS
  Medians baseline NIHSS score did not differ between groups of patients with and without RD (12.0 vs. 11.0 pts, p=0.33). Unfavourable outcome was found in 52.1% of patients with and in 41.2% of patients without RD (p=0.05), mortality was higher in patients with RD (29.9% vs. 14.3%, p<0.001), and the presence of haemorrhagic transformation (HT) did not differ between the groups (17.1% vs. 17.1% respectively, p=0.996). A multivariate analysis showed no impact of RD on the unfavourable outcome (OR 0.98; 95%CI 0.88-1.10), mortality (OR 0.92; 95%CI 0.81-1.05) or presence of HT (OR 1.03; 95%CI 0.90-1.18).
  
  
  CONCLUSIONS
  We found no impact of RD on the safety and efficacy of iv-thrombolysis in Caucasian patients with IS.
authors: Department of Neurology and Stroke Unit of Hospital in Sandomierz, Sandomierz, Poland. piotrsobolewski@poczta.onet.pl
authors: P
authors: P
authors: Sobolewski
authors: G
authors: G
authors: Kozera
authors: R
authors: R
authors: Kaźmierski
authors: S
authors: S
authors: Michalak
authors: W
authors: W
authors: Szczuchniak
authors: M
authors: M
authors: Śledzińska-Dźwigał
authors: W M
authors: WM
authors: Nyka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D003627:Data Interpretation, Statistical; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000150:complications* / Q000401:mortality; D007677:Kidney Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D044465:White People
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Cerebral thrombolysis; Glomerular filtration rate; Renal insufficiency; Stroke; rt-PA