Chronic kidney disease and the risk of stroke: a systematic review and meta-analysis

Masson, Philip; Webster, Angela C; Hong, Martin; Turner, Robin; Lindley, Richard I; Craig, Jonathan C.

doi:10.1093/ndt/gfv009

Cited by 237 publications

(191 citation statements)

References 28 publications

Supporting

Mentioning

170

Contrasting

Unclassified

Order By: Relevance

“…These data support the need for subsequent studies with larger sample size and longer follow-up to test if the better improvement in CVD risk indicators with F + V translates into fewer adverse CVD outcomes than treatment with oral NaHCO 3 . If such follow-up studies show that F + V compared to NaHCO 3 treatment of metabolic acidosis indeed yields fewer CVD outcomes, F + V might be preferred initial therapy for CKD-related metabolic acidosis, despite it being more challenging than NaHCO 3 to implement, given its potential to concomitantly reduce the substantial CVD risk in patients with CKD [2][3][4].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fruit and Vegetable Treatment of Chronic Kidney Disease-Related Metabolic Acidosis Reduces Cardiovascular Risk Better than Sodium Bicarbonate

et al. 2019

View full text Add to dashboard Cite

Background: Current guidelines recommend treatment of metabolic acidosis in chronic kidney disease (CKD) with sodium-based alkali. We tested the hypothesis that treatment with base-producing fruits and vegetables (F + V) better improves cardiovascular disease (CVD) risk indicators than oral sodium bicarbonate (NaHCO₃). Methods: We randomized 108 macroalbuminuric, matched, nondiabetic CKD patients with metabolic acidosis to F + V (n = 36) in amounts to reduce dietary acid by half, oral NaHCO₃ (HCO₃, n = 36) 0.3 mEq/kg bw/day, or to Usual Care (UC, n = 36) to assess the 5-year effect of these interventions on estimated glomerular filtration rate (eGFR) course as the primary analysis and on indicators of CVD risk as the secondary analysis. Results: Five-year plasma total CO₂ was higher in HCO₃ and F + V than UC but was not different between HCO₃ and F + V (difference p value < 0.01). Five-year net eGFR decrease was less in HCO₃ (mean –12.3, 95% CI –12.9 to –11.7 mL/min/1.73 m²) and F + V (–10.0, 95% CI –10.6 to –9.4 mL/min/1.73 m²) than UC (–18.8, 95% CI –19.5 to –18.2 mL/min/1.73 m²; p value < 0.01) but was not different between HCO₃ and F + V. Five-year systolic blood pressure was lower in F + V than UC and HCO₃ (p value < 0.01). Despite similar baseline values, F + V had lower low-density lipoprotein, Lp(a), and higher serum vitamin K1 (low serum K1 is associated with coronary artery calcification) than HCO₃ and UC at 5 years. Conclusion: Metabolic acidosis improvement and eGFR preservation were comparable in CKD patients treated with F + V or oral NaHCO₃ but F + V better improved CVD risk indicators, making it a potentially better treatment option for reducing CVD risk.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This enhanced mortality is due predominantly to increased risk for, and earlier onset of, cardiovascular disease (CVD) [1,2], including myocardial infarction [3] and cerebrovascular accident or stroke [4]. Metabolic acidosis further increases CVD and overall mortality risk in CKD [5].…”

Section: Introductionmentioning

confidence: 99%

Fruit and Vegetable Treatment of Chronic Kidney Disease-Related Metabolic Acidosis Reduces Cardiovascular Risk Better than Sodium Bicarbonate

et al. 2019

View full text Add to dashboard Cite

show abstract

“…3 Stroke and CKD share a common cardiovascular risk factors including high blood pressure, smoking, high cholesterol and diabetes. Although CKD had been recognized as a risk factor for stroke with a glomerular filtration rate (GFR) of <60 mL/ min/1.73 m 2 , little is known about the prevalence of renal dysfunction in the setting of ischemic stroke 4 .…”

Section: Introduction:-mentioning

confidence: 99%

Baseline Renal Dysfunction in Acute Ischemic Stroke Patients: Prevalence and Impact on Early Mortality.

Mahmoud.¹,

Badawy.²,

Shehta³

et al. 2017

IJAR

View full text Add to dashboard Cite

“…Atrial fibrillation has a prevalence of 9%–29% in chronic kidney disease 13. The increased risk of thrombotic stroke in this setting needs to be balanced against the increased risk of bleeding.…”

Section: Stroke and Chronic Kidney Diseasementioning

confidence: 99%

Neurological consults on the renal unit

Kelly

Clarkson

Cronin³

2017

Pract Neurol

View full text Add to dashboard Cite

Neurological symptoms commonly occur in chronic kidney disease and may result from its treatments and complications. Impaired renal function also influences treatments for other neurological conditions, requiring various cautions, dose adjustments and timing considerations, particularly in the context of renal replacement therapy. In this review, we present six illustrative clinical vignettes to highlight these challenges.

show abstract

Chronic kidney disease and the risk of stroke: a systematic review and meta-analysis

Abstract: Stroke risk increases linearly and additively with declining GFR and increasing albuminuria. CKD staging may also be a useful clinical tool for identifying people who may benefit most from interventions to reduce cardiovascular risk.

Cited by 237 publications

References 28 publications

Fruit and Vegetable Treatment of Chronic Kidney Disease-Related Metabolic Acidosis Reduces Cardiovascular Risk Better than Sodium Bicarbonate

Fruit and Vegetable Treatment of Chronic Kidney Disease-Related Metabolic Acidosis Reduces Cardiovascular Risk Better than Sodium Bicarbonate

Baseline Renal Dysfunction in Acute Ischemic Stroke Patients: Prevalence and Impact on Early Mortality.

Neurological consults on the renal unit

Contact Info

Product

Resources

About