CKD is associated with recurrent ischemia but not with hemorrhagic transformation in acute ischemic stroke patients

Abstract

Background: We investigated the associations of Recurrent Ischemic Stroke (RIS) and Hemorrhagic Transformation (HT) with CKD in acute ischemic stroke patients. Method: The subjects were 160 patients, divided into two groups: with eGFR 560 mL/min/1.73 m 2 (CKD), with eGFR !60 mL/min/1.73 m 2 (without CKD). Results: Subjects having DM (p ¼ 0.018), CKD (p ¼ 0.025) and treated with ACEI/ARB (p ¼ 0.039) revealed association with RIS. Regression analysis disclosed only CKD (p ¼ 0.04). Carotid artery stenosis (p ¼ 0.030) and serum calcium levels (p ¼ 0.013) showed significant association with HT. Conclusion: Our results disclosed that CKD could be a risk factor for RIS. There is no relation between CKD and HT.

Glomerular Filtration Rate is Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients without Thrombolytic Therapy

“…The present study demonstrated that low GFR was associated with increased risk of HT for AIS patients who did not receive thrombolysis therapy, which is in line with the result of two previous studies,[ 18 19 ] but slightly discriminating with the study of Micozkadioglu et al . [ 20 ] Nevertheless, it is worth mentioning that previous data possessed some unsolved restriction. In Lee et al .…”

“…'s study, it was attributed to only conducting the univariate analysis for variable of interest. They did not performed multivariate regression analysis to eliminate the confounding factors for GFR variable (e.g., carotid artery disease,[ 20 ] serum calcium,[ 20 ] AF,[ 18 ] large infarct volume,[ 17 37 ] hypertension,[ 38 ] and albuminuria[ 39 ]), which are powerful impact factors on HT for AIS patients and could cover or even inverse the actually correlation between GFR and HT. In our study, the inclusion of patients without thrombolysis only represents the considerable strengths, and multivariate regression analysis was also performed to ensure the robustness of the conclusions.…”

“…With regard to the HT prevalence, the present study revealed a similar HT rate (17.3%) with the previous studies. [ 18 20 ] The baseline characteristics including clinical, laboratory, and radiological variables of patients (e.g., body mass index [BMI], prior stroke history, DM, hypertension, AF, large cerebral infarction, serum urea nitrogen, albumin and creatinine, and estimated GFR) with and without HT are shown in Table 1 .…”

“…demonstrated that no significant relationship existed between GFR and HT after ischemic stroke. [ 20 ] The aim of our prospective study was to determine whether the GFR level is associated with HT in consecutive AIS patients without thrombolytic therapy (TT) so as to eliminate the effect of thrombolysis, as a leading confounding factor for HT.…”

Lower Serum Calcium Level Is Associated With Hemorrhagic Transformation After Thrombolysis

“…Micozkadioglu et al found a slight elevation in admission serum calcium level in 27 HT patients out of 160 stroke patients. 11 However, multivariate analysis was not performed and the percentage of patients treated with IVT was not mentioned. In patients with acute intracerebral hemorrhage, admission serum calcium level was also found to be negatively related to hematoma volume.…”