Relationship between kidney damage and stroke types in Japanese patients

Kudo, Kosuke; Konta, Tsuneo; Degawa, Noriyuki; Saito, Shinjiro; Kondo, Rei; Kayama, Takamasa

doi:10.1007/s10157-012-0594-6

Cited by 12 publications

(26 citation statements)

References 17 publications

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“…Some reports state a correlation between decreased renal function and hemorrhagic stroke [4,5,6], and a few state that decreased GFR increases the risk of hemorrhagic stroke as well as ischemic stroke [7,8]. However, to our knowledge, this study is the first that has assessed the association between decreased GFR and the risk of HT after acute ischemic stroke.…”

Section: Discussionmentioning

confidence: 56%

“…Some reports show a strong and graded inverse association between glomerular filtration rate (GFR) and the risk of hemorrhagic stroke that was independent of other vascular risk factors [4,5,6]. Others have revealed that renal dysfunction can also increase the risk of ischemic stroke [7,8]. However, there is no study on the association between GFR and hemorrhagic transformation (HT) after ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

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Low Glomerular Filtration Rate Increases Hemorrhagic Transformation in Acute Ischemic Stroke

Lee

Jang

et al. 2013

Cerebrovasc Dis

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Background: Decreased glomerular filtration rate (GFR) can increase the risk of bleeding tendency and hemorrhagic stroke. However, the relationship between the levels of GFR and hemorrhagic transformation (HT) after acute ischemic stroke is largely unknown. The aim of this study was to assess whether GFR level is associated with HT in acute ischemic stroke. Methods: We reviewed 770 consecutive patients with acute ischemic stroke within 7 days from September 2007 to February 2012 in a prospective stroke registry database. We calculated the patient’s GFR using the Cockcroft-Gault equation, and divided them into 3 groups: ≥60, 30–59 and <30 ml/min/1.73 m². HTs were identified by follow-up computed tomography (CT) or magnetic resonance imaging, and were defined as (1) any degree of high density within the area of low attenuation of vascular territory on noncontrast brain CT, or (2) low-signal intensity area in gradient echo within high-signal intensity meaning acute infarct on diffusion-weighted imaging. Multivariable logistic regression analyses were used to estimate the risk of GFR for HT. Stratification analyses were done according to the presence of HT high risk factors: atrial fibrillation (AF), thrombolysis and large size infarction. Additional logistic regression model for symptomatic HTs was established with the same variables. Results: HTs were noted in 131 patients (17.0%) and symptomatic HTs in 63 patients (8.2%). In univariate analysis, HTs were more frequent in patients with AF (51.9 vs. 16.7%, p < 0.001) and large-size infarction (42.0 vs. 5.3%, p < 0.001). The risk of HT was associated with decreased GFR among 3 subgroups classified according to the value of estimated GFR: 49/394 (12.4%) in the GFR ≥60 group, 66/312 (21.2%) in the 30≤ GFR <59 group and 16/64 (25.0%) in the GFR <30 group (p = 0.002). We found a significant association between the GFR <30 group and HTs in acute ischemic stroke (OR 2.90; 95% CI 1.26–6.68, p = 0.012) after adjusting for other risk factors. Moreover, the incidence of HTs was higher in the subgroups without thrombolysis (OR 3.49; 95% CI 1.44–8.46) and without AF (OR 3.44; 95% CI 1.10–10.76). Decreased GFR also had a tendency of increasing symptomatic HTs (OR 2.39; 95% CI 0.72–7.94, p = 0.154). Conclusions: Low levels of GFR are associated with a high risk of HT after acute ischemic stroke. Further studies are needed to elucidate whether HT in the patients with renal insufficiency are related to a worse outcome after acute ischemic stroke.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Low Glomerular Filtration Rate Increases Hemorrhagic Transformation in Acute Ischemic Stroke

Lee

Jang

et al. 2013

Cerebrovasc Dis

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“…). There were a total of 41 896 participants: 13 241 had an IS; 6707 had an IS and were thrombolyzed; 3135 an ICH, 90 a TIA, and for 18 723 the pathology was not specified . Thirteen studies were performed in Europe , 10 in Asia , 6 in the United States , and 2 in Brazil .…”

Section: Resultsmentioning

confidence: 99%

Renal Dysfunction in Stroke Patients: A Hospital-Based Cohort Study and Systematic Review

Rowat

Graham

Dennis

2014

International Journal of Stroke

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“…The one-year mortality was significantly higher in stroke patients with kidney damage than in those without kidney damage and increased along with the progression of renal insufficiency [119]. In addition, proteinuria is an independent predictor of one-year mortality rate in patients with stroke.…”

Section: Manifestations Of Nonneurologic Complications After Sahmentioning

confidence: 99%

The Harmful Effects of Subarachnoid Hemorrhage on Extracerebral Organs

Chen

et al. 2014

BioMed Research International

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Subarachnoid hemorrhage (SAH) is a devastating neurological disorder. Patients with aneurysmal SAH develop secondary complications that are important causes of morbidity and mortality. Aside from secondary neurological injuries, SAH has been associated with nonneurologic medical complications, such as neurocardiogenic injury, neurogenic pulmonary edema, hyperglycemia, and electrolyte imbalance, of which cardiac and pulmonary complications are most common. The related mechanisms include activation of the sympathetic nervous system, release of catecholamines and other hormones, and inflammatory responses. Extracerebral complications are directly related to the severity of SAH-induced brain injury and indicate the clinical outcome in patients. This review provides an overview of the extracerebral complications after SAH. We also aim to describe the manifestations, underlying mechanisms, and the effects of those extracerebral complications on outcome following SAH.

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Relationship between kidney damage and stroke types in Japanese patients

Abstract: This study shows that kidney damage is common in Japanese stroke patients, and proteinuria and renal insufficiency are differentially related to development and prognosis, depending stroke types.

Cited by 12 publications

References 17 publications

Low Glomerular Filtration Rate Increases Hemorrhagic Transformation in Acute Ischemic Stroke

Low Glomerular Filtration Rate Increases Hemorrhagic Transformation in Acute Ischemic Stroke

Renal Dysfunction in Stroke Patients: A Hospital-Based Cohort Study and Systematic Review

The Harmful Effects of Subarachnoid Hemorrhage on Extracerebral Organs

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