Abstract TP356: Renal Function and In-Hospital Outcomes in Patients With Acute Cerebrovascular Disease: Results From Chinese Stroke Center Alliance

Background and Purpose: To investigate the association of renal function with in-hospital death and recurrent stroke in patients with acute stroke. Methods: Data were from the Chinese Stroke Center Alliance (CSCA) with a sample of 511 036 patients. Baseline eGFR was calculated with the Chinese modification of CKD-EPI equation and categorized into 4 groups. Logistic regression models with generalized estimating equations were used to evaluate the risks for in-hospital death and recurrent stroke among eGFR categories with and without stratification for hypertension, diabetes mellitus (DM) and atrial fibrillation (AF). A cubic spline smoothing technique was used to interpolate the overall trend of risks through the range of eGFR. Results: Of 501 497 patients, 70.1% had an eGFR ≥90, 21.7% an eGFR 60 to 89, 4.1% an eGFR 45 to 59, 4.1% an eGFR<45 mL/min/1.73 m 2 . In-hospital death occurred in 3.0% of patients with an eGFR of <45, 1.5% an eGFR of 45 to 59, 0.9% an eGFR of 60 to 89, and 0.5% an eGFR ≥90. Recurrent stroke occurred in 7.6%, 7.2%, 6.5% and 5.9% respectively. Compared with eGFR ≥ 90, the adjusted odds ratios with 95% CI of eGFR <45, 45-59 and 60-90 were 3.97 (3.42-4.61), 1.95 (1.70-2.45) and 1.37 (1.22-1.53) for in-hospital death and 1.02 (0.94-1.11), 0.98 (0.91-1.06) and 0.98 (0.93-1.03) for recurrent stroke. A significantly statistical interaction between DM and categories of eGFR for stroke recurrent was identified (interaction P =0.001). The other results were almost consistent in stratified analyses by hypertension, DM or AF. There was a J-shaped relationship between eGFR and in-hospital death. A linear relationship was observed between eGFR and recurrent stroke. Conclusions: Low eGFR was associated with increased risk of all-cause mortality but not with recurrent stroke in patient with acute stroke.