Sobolewski P, Kozera G, Kaźmierski R, Michalak S, Szczuchniak W, Śledzińska-Dźwigał M, Nyka WM. Intravenous rt-PA in patients with ischaemic stroke and renal dysfunction.
Clin Neurol Neurosurg 2013;
115:1770-4. [PMID:
23643179 DOI:
10.1016/j.clineuro.2013.04.006]
[Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 03/25/2013] [Accepted: 04/08/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE
Renal dysfunction (RD) increases risk for ischaemic stroke (IS). The impact of RD on the effects of iv-thrombolysis in the Caucasian population has not been fully determined.
AIMS
To evaluate the associations between RD and the outcome of iv-thrombolysis in Caucasian patients with IS.
METHODS
The observational, multicentre study included 404 patients with IS who were treated with iv-thrombolysis. RD was defined as estimated glomerular filtration rate ≤ 60 ml/min/1.73 m(2). Outcome was assessed with modified Rankin Score at 3 months after the stroke onset.
RESULTS
Medians baseline NIHSS score did not differ between groups of patients with and without RD (12.0 vs. 11.0 pts, p=0.33). Unfavourable outcome was found in 52.1% of patients with and in 41.2% of patients without RD (p=0.05), mortality was higher in patients with RD (29.9% vs. 14.3%, p<0.001), and the presence of haemorrhagic transformation (HT) did not differ between the groups (17.1% vs. 17.1% respectively, p=0.996). A multivariate analysis showed no impact of RD on the unfavourable outcome (OR 0.98; 95%CI 0.88-1.10), mortality (OR 0.92; 95%CI 0.81-1.05) or presence of HT (OR 1.03; 95%CI 0.90-1.18).
CONCLUSIONS
We found no impact of RD on the safety and efficacy of iv-thrombolysis in Caucasian patients with IS.
Collapse