Impaired renal function is not associated with increased volume of intracerebral hemorrhage

Abstract

Background: Patients with low glomerular filtration rate (GFR) are at risk for hemorrhagic stroke and experience poor long-term outcomes after stroke. These associations may be mediated by hematoma volume. We investigated the relationship between impaired renal function (GFR <60 mL/min/1.73 m(2)) and hematoma size.

Methods: Consecutive patients admitted with spontaneous intracerebral hemorrhage (sICH) between August 2006 and January 2010 were evaluated; patients with acute kidney injury or end stage renal disease were excluded. Data on patient demographics, admission creatinine, size and location of bleed, and disposition at discharge were collected. Hematoma size and location and discharge outcomes were compared among those with normal and impaired renal function.

Results: Among 573 patients admitted with sICH, 411 met our study criteria (mean age 61.4 years; 52.3% female; median ICH volume 11.2 mL). Mean GFR was 73.8 mL/min/1.73 m(2), and 99 patients (24.1%) had a GFR <60 mL/min/1.73 m(2). There was no correlation between admission GFR and ICH volume (rs = 0.014; P = .77); those with GFR <60 versus ≥60 mL/min/1.73 m(2) also had similar ICH volumes (median 10.8 v 11.4 mL; P = .54). There was no association between in-hospital mortality and admission GFR, although those with GFR <60 mL/min/1.73 m(2) were more likely to die or be discharged to nursing homes (adjusted odds ratio 1.9; P = .03).

Conclusions: In a large sICH cohort, impaired renal function was not associated with final hematoma volume. Additional study should focus on the mechanism by which renal function impacts functional outcomes after sICH.

Keywords: Cerebral hematoma; glomerular filtration rate; kidney disease.