Prognostic Significance of Estimated Glomerular Filtration Rate and Cystatin C in Patients with Acute Intracerebral Hemorrhage

Cerebrovasc Dis. 2016;42(5-6):455-463. doi: 10.1159/000448340. Epub 2016 Aug 27.

Abstract

Background: The effects of the estimated glomerular filtration rate (eGFR) and cystatin C on clinical outcomes on intracerebral hemorrhage (ICH) remain unclear. We investigated the associations of eGFR and cystatin C with 3-month functional outcome and all-cause mortality in acute ICH patients.

Methods: A total of 365 patients with acute ICH were enrolled. Serum creatinine and cystatin C levels were measured within 24 h of admission. Outcomes at 3-month were evaluated by interviews with patients or their family members. Poor functional outcome was defined as a modified Rankin Scale score ≥3.

Results: During the 3-month follow-up, 154 patients experienced poor functional outcome, and 48 patients died from all causes. Low eGFR level was associated with poor outcome (adjusted OR 8.95; 95% CI 2.13-37.66; p-trend = 0.045) and all-cause mortality (adjusted hazards ratio (HR) 5.10; 95% CI 2.00-13.03; p-trend = 0.001). Additionally, a high cystatin C level was also found to be associated with all-cause mortality (adjusted HR 4.01; 95% CI 1.09-14.72; p-trend = 0.015). However, no significant association between cystatin C and poor functional outcome was observed (p-trend = 0.615).

Conclusions: Low eGFR at baseline predicts poor functional outcome and all-cause mortality at 3-month in acute ICH patients. Also, high cystatin C was associated with increased risk of mortality but not with poor functional outcome.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cerebral Hemorrhage / blood
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / mortality
  • Cerebral Hemorrhage / physiopathology
  • Chi-Square Distribution
  • Cystatin C / blood*
  • Disability Evaluation
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kaplan-Meier Estimate
  • Kidney / physiopathology*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Recovery of Function
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / mortality
  • Renal Insufficiency, Chronic / physiopathology
  • Risk Factors
  • Time Factors
  • Young Adult

Substances

  • Biomarkers
  • CST3 protein, human
  • Cystatin C