Effects of Estimated Glomerular Filtration Rate on Clinical Outcomes in Patients with Intracerebral Hemorrhage

Background: The influence of chronic kidney disease (CKD) on severity and prognosis of spontaneous intracerebral hemorrhage (ICH) is scarcely investigated. We aimed to explore the association of admission estimated glomerular filtration rate (eGFR) levels with stroke severity and outcomes in ICH patients. Materials and Methods: The patients enrolled in this study were from the China Stroke Center Alliance study (CSCA). Patients were divided into four groups according to different admission eGFR levels (≥90;60-89;45-59;<45). Multivariable logistic regression analysis was used to determine the association of admission eGFR levels with stroke severity, in-hospital complications, discharge deposition, and in-hospital mortality after ICH. Results: 85167 patients with acute ICH were included in the present analysis. Among them, 9493 (11.1%) had baseline eGFR＜60 ml/min/1.73 m 2 . Low eGFR was associated with increasing risk of in-hospital mortality [eGFR 60-89 ml/min/1.73 m 2 , odds ratios(OR) 2.07(95% confidence interval(CI) 0.45 -9.4); eGFR 45-59, 8.43 (1.15- 61.98); eGFR＜45, 13.92 (2.22 - 87.15); P for trend < 0.0001]after adjusting for the confounding factors. With the declining of eGFR, the risk of non-routine disposition and hematoma evacuation increased in patients with eGFR 45 to 59 ml/min/1.73 m 2 (OR 8.43; 95%CI 1.15-61.98 and OR 3.36; 95% CI 1.2-9.44, respectively). No significant association between different level of eGFR at baseline and stroke severity, in-hospital complication such as pneumonia, hydrocephalus, rebleeding were observed. Conclusions: Low eGFR at baseline was associated with increased risk of in-hospital mortality, non-routine disposition and hematoma evacuation but not with stroke severity and in-hospital complications in acute ICH patients.