title: Reduced estimated glomerular filtration rate affects outcomes 3 months after intracerebral hemorrhage: the stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study.
abstract: BACKGROUND
  The effect of renal dysfunction on intracerebral hemorrhage (ICH) remains unclear. We investigated associations of renal dysfunction assessed by estimated glomerular filtration rate (eGFR) with clinical courses and outcomes in ICH patients.
  
  
  METHODS
  From a prospective, multicenter, observational study, 203 patients who had supratentorial ICH within 3 hours of onset were included. Patients were classified into 3 groups based on eGFR: Group 1 (eGFR < 60 mL/minute/m(2)), Group 2 (60-89), and Group 3 (≥ 90). Outcomes included neurologic deterioration within 72 hours, hematoma expansion (> 33% in volume) at 24 hours, and favorable (modified Rankin Scale [mRS] ≤ 2) or unfavorable (mRS ≥ 5) outcome at 3 months.
  
  
  RESULTS
  Thirty-seven patients (16 women, 74.6 ± 13.2 years) were assigned to Group 1, 99 (34 women, 65.2 ± 11.4 years) to Group 2, and 67 (30 women, 61.3 ± 9.4 years) to Group 3. Significant differences were found in age (P < .001) and initial systolic blood pressure among the groups (208.4 ± 18.0, 201.9 ± 15.1, and 198.1 ± 14.2 mm Hg for Group 1, 2, and 3, respectively; P = .006). Similar rates of neurologic deterioration (14%, 6%, and 6%) and hematoma expansion (16%, 14%, and 18%) were observed among the groups. However, in Group 1, favorable outcome was less frequent (17%, 48%, and 42%; P = .002) and unfavorable outcome was more frequent (24%, 7%, and 6%; P = .013) than in the other groups. After adjustment for confounders, eGFR < 60 mL/minute/m(2) was independently associated with both favorable outcome (odds ratio [OR], .21; 95% CI, .07-.54) and unfavorable outcome (OR, 5.64; 95% CI, 1.80-18.58).
  
  
  CONCLUSIONS
  Renal dysfunction (eGFR < 60 mL/minute/m(2)) was associated with poor clinical outcome after ICH.
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Miyagi
authors.affiliation: Department of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address: koga@ncvc.go.jp.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.affiliation: Department of Neurology, Stroke Center, Kobe City General Hospital, Kobe, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.affiliation: Department of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okuda
authors.affiliation: Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Departments of Neurosurgery and Stroke Center, Kyorin University School of Medicine, Mitaka, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shiokawa
authors.affiliation: Department of Neurosurgery and Stroke Center, Nakamura Memorial Hospital, Sapporo, Japan.
authors.forename: Jyoji
authors.initials: J
authors.lastname: Nakagawara
authors.affiliation: Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Furui
authors.affiliation: Department of Neurology, St Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.affiliation: Department of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Arihiro
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Glomerular filtration rate; intracerebral hemorrhage; outcome; renal dysfunction