Abstract
Background: acute renal impairment is a common complication after acute stroke. More
than one fourth of patients developed acute kidney injury in the first 2 days after the ictus.
Aim of the work: To study the prevalence of acute renal impairment in acute stroke patients
and to study the clinical characteristics, laboratory and radiological findings of stroke patients
with and without acute kidney injury.
Subjects and Methods: The study included 500 patients admitted to the Neurology
department of Sohag university hospital, Alhelal hospital and Sohag general hospital
presented by stroke within the first 48 hours. Patients with a history of renal disease or
receiving dialysis for chronic renal failure were excluded. Patients were subjected to detailed
medical and neurological evaluation. Stroke severity assessed by NIHSS, Glasgow coma
scale and MRCS of power. CT brain was done for all patients and laboratory studies were
done including serum urea, creatinine, calculated creatinine clearance, uric acid, electrolyte
assessment, random blood sugar, liver functions test, coagulation profile and complete blood
count and erythrocyte sedimentation rate.
Results: Renal impairment was reported in 122 patients (24.4%). The mean age “mean ±
SD” of patients without AKI was 61.61±12.977 and that of patients with AKI was
64.71±10.653. In patients without AKI, the percentage of male was 52.1% and in patients
with AKI, male percentage was 56.5%. In patients without AKI, we reported the following;
hypertension (25.1%), ACEIs (44%), atrial fibrillation (10.8%), coma (2.8%), DM (36.5%),
hyperlipidemia (34.1%), smoking (29.6%), cardiac disease (31.4%), hyperuricemia (14%),
TIA (1.8%), drug abuse (3.1%), mean Na level (139.6±6.6), mean K+ (4.2±1.6), mean Ca++
(9.1±.5), echogenic grade (I) kidney on U/S (7.4%), cerebral infarction (68%), cerebral
hemorrhage (31%) and hemorrhagic infarction (0.7%). In patients with AKI, we reported the
following; hypertension (19.6%), ACEIs (55%), atrial fibrillation (11.4%), coma (5.4%), DM
(36.8%), hyperlipidemia (30.3%), smoking (23.7%), cardiac disease (26.2%), hyperuricemia
(25%), TIA (1.6%), drug abuse (7.3%), mean Na level (134.9±6.3), mean K+ (4.2±.9), mean
Ca++ (8.5±.8), echogenic grade (I) kidney on U/S (59.1%), cerebral infarction (56.5%) and
cerebral hemorrhage (41%).
Conclusion: we found that the prevalence of renal impairment in acute stroke patients is
24.4% and its predictors were age, conscious level, presence of speech abnormality,
hypertension, hyperuricemia, RHD, drug abuse, presence of casts, crystals and albumin in
urine, elevated ALT enzyme, leucocytosis and high ESR.