Chronic kidney disease, serum uric acid and acute ischemic stroke

Background:Both chronic kidney disease(CKD) and serum uric acid levels(SUA) were associated to an increased risk of acute ischemic stroke(AIS). This higher risk is mediated by several mechanisms including platelet dysfunction, coagulation disorders, endothelial dysfunction, inflammation, and increased risk of atrial fibrillation(AF).Materials and Methods: We enrolled 294 consecutive patientsadmitted for AIS and collected age, sex, lenght of admission, in-hospital mortality and comorbidities (hypertension, diabetes, chroniccardiopathy, AF, dyslipidemia, active cancer, COPD, CKD anddementia). Survival was performed with Kaplan-Meier and Coxregression (forward stepwise method) analysis with SPSS 13.0.Results: Mean age was 82,37 (±9,19) years. Mean length of stay inIM was 9,87 (±7,14) days. In-hospital mortality was 7,1%.Patientswith SUA >7,0mg/dl had an increased risk of in-hospital mortality atKaplan-Meier’s regression (p<0,05, log-rank test). Cox regression model, including all the collected comorbidities, age and sex showed that, in the overall sample, high serum uric acid was independently associated to an increased risk of in-hospital mortality (OR: 3,873;95% CI: 1,567-9,573; p<0,05). This effect was even more evident among patients with CKD, defined as eVFG<60 ml/min (OR: 5,863;95% CI: 1,403-20,501; p<0,05), while SUA was not associated to a worse outcome among patients with normal renal function.Conclusions: In this population of elderly patients affected by AIS,SUA predicted an increased in-hospital mortality only in the subpopulation affected by CKD.