スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	High urinary albumin/creatinine ratio at admission predicts poor functional outcome in patients with acute ischaemic stroke
掲載誌名	正式名：NEPHROLOGY ISSNコード：1320-5358/1440-1797
出版社	WILEY
巻・号・頁	22(3),199-204頁
著者・共著者	Yoko Watanabe,Satoshi Suda,Takuya Kanamaru,Toshiya Katsumata,Seiji Okubo,Tomohiro Kaneko,Akiko Mii,Yukinao Sakai,Yasuo Katayama,Kazumi Kimura,Shuichi Tsuruoka
発行年月	2017/03
概要	Aim: Albuminuria and a low estimated glomerular filtration rate (eGFR) are widely recognized indices of kidney dysfunction and have been linked to cardiovascular events, including stroke. We evaluated albuminuria, measured using the urinary albumin/creatinine ratio (UACR), and the eGFR in the acute phase of ischaemic stroke, and investigated the clinical characteristics of ischaemic stroke patients with and those without kidney dysfunction. Methods: The study included 422 consecutive patients admitted between June 2010 and May 2012. General blood and urine examinations were performed at admission. Kidney dysfunction was defined as a low eGFR (< 60mL/min per 1.73m(2)), high albuminuria (30mg/g creatinine), or both. Neurological severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) at admission and the modified Rankin scale (mRS) at discharge. A poor outcome was defined as a mRS score of 3-5 or death. The impacts of the eGFR and UACR on outcomes at discharge were evaluated using multiple logistic regression analysis. Results: Kidney dysfunction was diagnosed in 278 of the 422 patients (65.9%). The eGFR was significantly lower and UACR was significantly higher in patients with a poor outcome than in those with a good outcome. In multivariate analyses performed after adjusting for confounding factors, UACR > 31.2mg/g creatinine (OR, 2.58; 95% CI, 1.52-4.43; P=0.0005) was independently associated with a poor outcome, while a low eGFR was not associated. Conclusions: A high UACR at admission may predict a poor outcome at discharge in patients with acute ischaemic stroke.
DOI	10.1111/nep.12745
PMID	26860421