Evidence map›Paper›PMID 31250340›Full record

ArticleInternational urology and nephrology2019

Under-recognized post-stroke acute kidney injury: risk factors and relevance for stroke outcome of a frequent comorbidity.

Fabrizio Grosjean, Michela Tonani, Rosario Maccarrone, Carlo Cerra, Federica Spaltini, Annalisa De Silvestri, Francesco Falaschi, Simona Migliazza, Carmine Tinelli, Teresa Rampino and 2 more

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Article in International urology and nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Fabrizio GrosjeanUnit of Nephrology, Dialysis, Transplantation, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy. f.grosjean@smatteo.pv.it.
Michela TonaniUnit of Cardiac and Cerebrovascular Disease-General Medicine 2, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Pavia, Italy.
Rosario MaccarroneUnit of Nephrology, Dialysis, Transplantation, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy.
Carlo CerraUnit of Informative System and Management Control, ASST of Pavia, Pavia, Italy.
Federica SpaltiniSchool of Medicine, University of Pavia, Pavia, Italy.
Annalisa De SilvestriService of Clinical Epidemiology and Biometry, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Francesco FalaschiGeneral Medicine 2, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Pavia, Italy.
Simona MigliazzaUnit of Informative System and Management Control, ASST of Pavia, Pavia, Italy.
Carmine TinelliService of Clinical Epidemiology and Biometry, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Teresa RampinoUnit of Nephrology, Dialysis, Transplantation, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Viale Golgi 19, 27100, Pavia, Italy.
Antonio Di SabatinoGeneral Medicine 2, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Pavia, Italy.
Alessandra MartignoniUnit of Cardiac and Cerebrovascular Disease-General Medicine 2, Foundation I.R.C.C.S. Policlinico San Matteo, University of Pavia, Pavia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) is emerging as a predictor of poor stroke outcome, however, it is often not recognized. The aim of our study was to evaluate post-stroke AKI burden, AKI risk factors and their influence in post-stroke outcome.

methodsFrom 2013 to 2016, 440 individuals with stroke diagnosis admitted in Stroke Unit, Foundation IRCCS Policlinico San Matteo (Pavia, Italy), were retrospectively enrolled. AKI cases identified by KDIGO criteria through the electronic database and hospital chart review were compared with the ones reported in discharge letters or in administrative hospital data base. Mortality data were provided by Agenzia Tutela della Salute of Pavia.

resultsWe included 430 patients in the analysis. Median follow-up was 19.2 months. We identified 79 AKI cases (18% of the enrolled patients, 92% classified as AKI stage 1), a fivefold higher number of cases than the ones reported at discharge. 37 patients had AKI at the admission in the hospital, while 42 developed AKI during the hospitalization. Cardioembolic (p = 0.01) and hemorrhagic (p = 0.01) stroke types were associated with higher AKI risk. Admission National Institutes of Health Stroke Scale (NIHSS, p < 0.05) and Charlson Comorbidity Index (p < 0.01) were independently associated with overall AKI, while admission NIHSS (p < 0.05) and eGFR (p < 0.005) were independently associated with AKI developed during the hospitalization. AKI was associated to longer in-hospital stay (p = 0.01), worse Rankin Neurologic Disability Score at discharge (p < 0.0001) and discharge disposition other than home (p = 0.03). AKI was also independently associated to higher in-hospital mortality (OR 3.9 95% CI 1.2-12.9 p = 0.023) but not with long-term survival.

conclusionsPost-stroke AKI diagnosis needs to be improved by strictly monitoring individuals with cardioembolic or hemorrhagic stroke, reduced kidney function, higher Charlson Comorbidity Index and worse NIHSS at presentation.

Indexed as

Acute Kidney InjuryAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsStrokeTreatment OutcomeAcute renal failureCerebrovascular accidentDisability

Identifiers

PMID31250340

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.