Pathogenetic Subtypes and Ischemic Stroke Outcomes in Patients with Chronic Kidney Disease

Abstract

A study has been conducted to investigate the relationships between the risk of developing various pathogenetic subtypes of ischemic stroke (IS) and its outcomes with chronic kidney disease (CKD). A retrospective study was conducted in the group of IS patients (n=1070): with CKD (n=343) and without CKD (n=727). TOAST classification was used to determine IS subtypes. The study data showed that in patients with CKD compared to patients without CKD, TOAST2 frequency was more common in total group (p<0.0001; OR=1.878 (1.423-2.478)), among men (p<0.001; OR=2.008 (1.370-2.943)) and among women (p=0.009; OR=1.720 (1.145-2.584)); TOAST1 frequency was rare in total group (p<0.0001; OR=0.565 (0.435-0.734)), among men (p<0.0001; OR=0.502 (0.353-0.713)) and among women (p=0.042; OR=0.665 (0.448-0.487)); stroke manifestations were more severe an NIHSS scale (p=0.0001), Glasgow coma scale (p=0.002); IS mortality was higher (13.7 % versus 7.4 %; p=0.001;) in total group and TOAST2 mortality was higher (25.0 % vs.14.9 %; p=0.027; OR=1.910 (1.072-3.404) in total group and among women (29.7 % versus 11.1 %; p=0.004; )). Conclusions. IS patients with CKD are more likely to develop cardioembolic stroke (p<0.0001; OR=1.878 (1.423-2.478)), have more severe stroke manifestations (NIHSS score, p=0.0001; Glasgow score, p=0.002), have higher cardioembolic stroke mortality among women (29.7 % versus 11.1 %; p=0.004;) compared to IS patients without CKD.