Estimated glomerular filtration rate and risk of survival in acute stroke (original) (raw)
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Journal of clinical neurology (Seoul, Korea), 2015
Chronic kidney disease (CKD) is an established risk factor for numerous cardiovascular diseases including stroke. The relationship between the baseline estimated glomerular filtration rate (eGFR) and clinical 3-month outcomes in patients with acute ischemic stroke were evaluated in this study. This was a prospective cohort study involving a hospital-based stroke registry; 1373 patients with acute ischemic stroke were enrolled. Patients were divided into the following four groups according their eGFR (calculated using the CKD Epidemiology Collaboration equations): ≥60, 45-59, 30-44, and <30 mL/min/1.73 m(2). The primary endpoint of poor functional outcome was defined as 3-month death or dependency (modified Rankin Scale score ≥3); secondary endpoints were neurological deterioration (increase in National Institutes of Health Stroke Severity score of ≥4 at discharge compared to baseline) during hospitalization and in-hospital mortality. The overall eGFR was 84.5±20.8 mL/min/1.73 m(2...
Renal dysfunction and 30-day mortality risk in patients with acute stroke
African Journal of Nephrology
interest in reduced glomerular filtration rate (GFR) as an independent non-traditional risk factor for CVD and CVD mortality has come to the fore [4,5]. Studies suggest that reduced GFR may be an independent risk factor for poor outcomes in patients with myocardial infarction and stroke [6-8]. Yohalom et al. [8], in a prospective study involving 821 Israeli adults with acute stroke, found that reduced GFR was a strong independent predictor of mortality and poor outcomes. Mortality was associated
Journal of Atherosclerosis and Thrombosis, 2018
Aim: Although renal dysfunction has been identified as a novel risk factor affecting stroke prognosis, few have analyzed the association within large-scale population-based setting, using wide-range estimated glomerular filtration rate (eGFR) category. We aimed to determine the association of admission eGFR with acute stroke outcomes using data from a registry established in Shiga Prefecture, Japan. Methods: Following exclusion of patients younger than 18 years, with missing serum creatinine data, and with onset more than 7 days prior to admission, 2,813 acute stroke patients registered in the Shiga Stroke Registry year 2011 were included in the final analysis. The Japanese Society of Nephrology equation was used to estimate GFR. Multivariable logistic regression was performed to analyze the association of eGFR with all-cause in-hospital death (modified Rankin Scale [mRS] 6), and atdischarge death/disability (mRS 2–6). Separate analyses were conducted within stroke subtypes. Results...
Medicine, 2017
Chronic kidney disease (CKD) is gradually recognized as an independent risk factor for cardiovascular and cardio-/cerebrovascular disease. This study aimed to examine the association of the estimated glomerular filtration rate (eGFR) and clinical outcomes at 3 months after the onset of ischemic stroke in a hospitalized Chinese population.Totally, 972 patients with acute ischemic stroke were enrolled into this study. Modified of Diet in Renal Disease (MDRD) equations were used to calculate eGFR and define CKD. The site and degree of the stenosis were examined. Patients were followed-up for 3 months. Endpoint events included all-cause death and newly ischemic events. The multivariate logistic model was used to determine the association between renal dysfunction and patients' outcomes.Of all patients, 130 patients (13.4%) had reduced eGFR (<60 mL/min/1.73 m), and 556 patients had a normal eGFR (≥90 mL/min/1.73 m). A total of 694 patients suffered from cerebral artery stenosis, i...
Renal function is associated with 1-month and 1-year mortality in patients with ischemic stroke
Atherosclerosis, 2017
Renal dysfunction is a potent risk factor for cardiovascular diseases, including stroke. This study aimed to evaluate the impact of admission estimated glomerular filtration rate (eGFR) levels on short-term (1-month) and long-term (1-year) mortality in patients with acute ischemic stroke. From the Taiwan Stroke Registry data, we classified ischemic stroke patients, identified from April 2006 to December 2015, into 5 groups by eGFR at admission: ≥ 90, 60-89, 30-59, 15-29, and <15 mL/min/1.73 m2 or on dialysis. Risks of 1-month mortality and 1-year mortality after ischemic stroke were investigated by the eGFR level. Among 52,732 ischemic stroke patients, 1480 died within one month. The 1-month mortality rate was over 5-fold greater in patients with eGFR <15 mL/min/1.73 m2 or dialysis than in patients with eGFR ≥90 mL/min/1.73 m2 (2.88 versus 0.56 per 1000 person-days). The adjusted hazard ratio (HR) of 1-month mortality increased from 1.31 (95% CI = 1.08-1.59) for patients with ...
Atherosclerosis, 2015
Atherosclerosis 239 (2015) 328e334 adjusted hazard ratio of 21.19 (95% CI, 9.69e46.35) in patients with NIHSS >15 and eGFR <15 mL/min/ 1.73 m 2 , compared with those with NIHSS 0e5 and eGFR 60e119 mL/min/1.73 m 2 . Conclusions: Low eGFR was significantly and independently associated with 6-month functional outcomes and mortality in patients with the LAA subtype of acute ischemic stroke. The deleterious relationship between low eGFR levels and mortality following stroke was exacerbated by its synergistic association with stroke severity.
Chronic Kidney Disease and Clinical Outcome in Patients With Acute Stroke
Stroke, 2009
Background and Purpose-Chronic kidney disease (CKD) is increasingly recognized as an independent risk factor for cardiovascular disease and stroke. Our aim was to examine the association between estimated glomerular filtration rate (GFR) and stroke outcome and to assess whether CKD and its severity affect stroke outcome in a large cohort of unselected patients with acute stroke. Methods-We examined the association between baseline estimated GFR and CKD and 1-year outcomes in 821 consecutive patients with acute stroke (ischemic or hemorrhagic). GFR was estimated by 2 methods: the Modification of Diet in Renal Disease and the Mayo Clinic quadratic equation. An estimated GFR rate Յ60 mL/min/1.73 m 2 defined CKD. Results-Odds ratios (95% CI) for death across levels of estimated GFR based on both equations were estimated. CKD was present in 36% of patients based on the Modification of Diet in Renal Disease equation and 18% (nϭ147) based on the Mayo Clinic equation. The adjusted ORs for mortality after 1-year based on the Modification of Diet in Renal Disease equation were 0.7 (95% CI, 0.4 to 1.2) associated with GFR 45 to 60 and 3.2 (1.7 to 6.4) associated with GFR 15 to 44 as compared with GFR Ͼ60 mL/min/1.73 m 2 , whereas those based on the Mayo Clinic equation were 2.3 (1.1 to 4.7) and 3.3 (1.6 to 7.1), respectively. The adjusted ORs for Barthel Index Յ75 or death after 1 year were 0.8 (0.5 to 1.5) and 2.1 (0.9 to 4.8) by the Modification of Diet in Renal Disease equation and 1.9 (0.8 to 4.4) and 3.9 (1.5 to 11.0) by the Mayo Clinic equation, respectively. Conclusions-CKD is a strong independent predictor of mortality and poor outcome in patients with acute stroke. The estimation of the prevalence of CKD and of the GFR cutoffs associated with poor outcome depend on the equation used to estimate GFR. (Stroke. 2009;40:1296-1303.)
Renal Function Predicts Outcomes in Ischemic Stroke and Hemorrhagic Stroke
International Journal of Science and Research, 2024
Renal dysfunction has been suggested as risk factor and prognostic factors in cerebrovascular diseases. Regarding the association of renal dysfunction with stroke subtypes, conflicting results have been observed. The aim of this study was to evaluate renal function and the impact of renal function on in-hospital outcomes in hospitalized patients with ischemic and hemorrhagic stroke. We conducted a retrospective cohort study in a sample of 311 hospitalized patients with acute stroke at Department of Neurology, Khmer Soviet Friendship Hospital from January 1, 2020 to June 30, 2021. Mann-Whitney test was used to compare the values of variables between the 2 groups. Multivariate logistic regression was used to identify the independent risk factors for mortality in stroke. In analysis of the impact of severity, variables were standardized for age by arbitrary inclusion of this variable in the model. In addition, for models with a larger number of independent variables, stepwise method was used to eliminate variables (as a criterion for accepting the value of the Wald statistics). Of 311 stroke patients, 52.73% were male and the mean age of 62 years old. There were 84.88% ischemic stroke. The mean serum creatinine on admission in patients with both types of stroke was significantly higher in hemorrhagic stroke. Multivariate analysis showed that independent predictors of severity in patients with ischaemic stroke were: ischemic heart disease or prior myocardial infarction, diabetes, admission glucose and eGFR on admission. Also, multivariate analysis showed that independent predictors of mortality in patients with haemorrhagic stroke were: age and admission glucose. Patients with haemorrhagic stroke, in particular with acute kidney injury during hospitalisation had significantly worse outcomes than patients with ischaemic stroke. Assessment of kidney function is prerequisite to employ the necessary measures to decrease the risk of in-hospital severity among patients with acute stroke. Appropriate approach to patients with renal dysfunction (adequate hydration, avoidance of nephrotoxic drugs, drug dose adjustment etc) should be considered as preventive and therapeutic strategies in the management of acute stroke.