LAUSR

BACKGROUND/AIM Chronic kidney disease (CKD) is associated with increased risk of stroke and mortality. We evaluated the clinical and imaging features and outcomes of patients with and without kidney impairment among patients admitted for acute ischemic stroke (AIS). METHODS AIS patients with brain-MRI were included in the study. Kidney impairment was defined by an admission eGFR<60 ml/min/1.73m2 . Cerebral microbleeds (CMB) and white matter hyperintensities (WMH) were evaluated using the Microbleed Anatomical Rating Scale and Fazekas scales, respectively. Primary outcomes were defined by modified Rankin scale (mRS) and discharge disposition. Multivariate logistic regression analysis was performed to evaluate factors associated with the presence of kidney impairment and poor discharge outcomes. RESULTS Of the 285 patients with AIS, 80 had kidney impairment on admission. Patients with kidney impairment were older (mean age±SD: 74.7±12.9 vs. 64.4±13.8 years, p<0.0001) and had more neurological deficits on National Institutes of Health stroke scale (NIHSS) score (median 8.5 vs. 5, p=0.02). In unadjusted analysis, patients with kidney impairment were less likely to have a good functional outcome (mRS 0-2: 36% vs 57%, p=0.002) and good discharge outcome (home or inpatient rehabilitation: 68% vs 82%, p=0.008). On multivariate analysis, kidney impairment was associated with higher NIHSS score (OR=1.04; 95%CI=1.002-1.08) and severe WMH (OR=1.99; 95%CI=1.06-3.77) suggestive of small vessel disease but kidney impairment was not associated with poor discharge outcome (OR=1.62; 95% CI:0.75-3.53). CONCLUSION Presence of kidney impairment at the time of stroke presentation, regardless of previous renal function, is associated with more neurological deficits and severe WMH on MRI. This article is protected by copyright. All rights reserved.