title: Acute renal failure is associated with higher death and disability in patients with acute ischemic stroke: analysis of nationwide inpatient sample.
abstract: OBJECTIVE
  Acute renal failure (ARF) in setting of acute ischemic stroke (AIS) is associated with worse outcome. We sought to determine the prevalence of ARF and effect on outcomes of patients with AIS.
  
  
  METHODS
  Data from all patients admitted to US hospitals between 2002 and 2010 with a primary discharge diagnosis of ischemic stroke and secondary diagnosis of ARF were included. The effect of ARF on rates of intracerebral hemorrhage and discharge outcomes was analyzed after adjusting for potential confounders using logistic regression analysis.
  
  
  RESULTS
  Of 7,068,334 patients with AIS, 372,223 (5.3%) had ARF during hospitalization. Dialysis was required in 2364 (0.6%) of 372,223 patients. Patients with AIS with ARF had higher rates of moderate to severe disability (41.3% versus 30%; P<0.0001), intracerebral hemorrhage (1.0% versus 0.5%; P<0.0001), and in-hospital mortality (8.4% versus 2.9%; P<0.0001) compared with those without ARF. After adjusting for confounding factors, patients with AIS with ARF had higher odds of moderate to severe disability (odds ratio, 1.3; 95% confidence interval, 1.3-1.4; P<0.0001), intracerebral hemorrhage (odds ratio, 1.4; 95% confidence interval, 1.3-1.6; P<0.0001), and death (odds ratio, 2.2; 95% confidence interval, 2.0-2.2; P<0.0001).
  
  
  CONCLUSIONS
  ARF in patients with AIS is associated with significantly higher rates of moderate to severe disability at discharge and in-hospital mortality.
authors.affiliation: From the Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH (F.S.); Zeenat Qureshi Stroke Institute, St. Cloud, MN (M.M.A., A.I.Q.); Department of Neurology, Louisiana State University Health Science Center, New Orleans, LA (F.K., L.A.B.); Department of Medicine, University of Rochester Medical Center, Rochester, NY (U.A.D.); and Department of Neurology, Ochsner Clinic Foundation, New Orleans, LA (G.A.V.).
authors.forename: Fahad
authors.initials: F
authors.lastname: Saeed
authors.forename: Malik M
authors.initials: MM
authors.lastname: Adil
authors.forename: Faraz
authors.initials: F
authors.lastname: Khursheed
authors.forename: Usama A
authors.initials: UA
authors.lastname: Daimee
authors.forename: Lionel A
authors.initials: LA
authors.lastname: Branch
authors.forename: Gabriel A
authors.initials: GA
authors.lastname: Vidal
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D004185:Disability Evaluation; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D006435:Renal Dialysis / Q000706:statistics & numerical data; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D014481:United States / Q000453:epidemiology
keywords: acute ischemic stroke; acute renal failure