To Assess the Risk of Kidney Injury in Young Patients Presenting with Stroke in A Tertiary Care Centre

Abstract Introduction: Stroke is one of the leading causes of disability and mortality worldwide. While neurological outcomes are well studied, systemic complications such as acute kidney injury (AKI) are often overlooked, despite their significant impact on prognosis. AKI following stroke can prolong hospitalization, increase mortality, and predispose patients to chronic kidney disease (CKD). The burden is especially relevant in young adults, who are increasingly presenting with stroke and may face lifelong consequences. This study was designed to assess the risk of kidney injury in young stroke patients and to analyze its associations with clinical and biochemical risk factors. Aims and Objectives: The primary objective was to assess the risk of AKI in young stroke patients. Secondary objectives were to evaluate associations between AKI and stroke subtype (ischemic vs. hemorrhagic), determine transient versus persistent renal dysfunction, and study correlations between AKI and comorbidities such as hypertension, diabetes, and albuminuria. Materials and Methods: This cross-sectional analytical study was conducted at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, over one year. Eighty patients aged 18–49 years with first-ever ischemic or hemorrhagic stroke within 72 hours of onset were included. Patients with pre-existing CKD or confounding conditions were excluded. Renal function was assessed using estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR) at admission and on day seven. Statistical analysis was performed using SPSS v20, with p<0.05 considered significant. Results: of the 80 patients, mean age was 36 years, with slight female predominance (52.5%). Hypertension was highly prevalent (88.75%), while diabetes was observed in 22.5%. AKI developed in 36 patients (45%): 26 (32.5%) transient and 10 (12.5%) persistent. Ischemic stroke (61.25% of cases) was strongly associated with AKI, accounting for 86.1% of all AKI cases (p<0.001). Hypertension showed a significant correlation with renal dysfunction, particularly in Stage II and hypertensive crisis categories, while diabetes did not. Albuminuria was a strong predictor: 75% of patients with microalbuminuria and all with microalbuminuria developed AKI. Conclusion: Young stroke patients are at a substantial risk of renal dysfunction, particularly those with ischemic stroke and hypertension. While most AKI cases were transient, a significant proportion had persistent dysfunction, raising the risk of CKD. Albuminuria proved to be a reliable early marker of renal injury. These findings underscore the need for routine renal monitoring, early detection strategies, and targeted management in young stroke patients to improve long-term outcomes.