Stroke and Chronic Kidney Disease

Kelly, Dearbhla M.; Kelleher, Eoin; Sood, Manish M.

doi:10.1159/000517698

Cited by 8 publications

(6 citation statements)

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“…This retrospective analysis of a prospective study confirms that impaired kidney function in acute stroke patients is associated with higher rates of vascular events and mortality [1, 2, 4, 8]. Patients with reduced kidney function (eGFR < 60 ml/min/1.73 m 2 ) at baseline had a higher rate of recurrent vascular events and death within 24 months compared to those with nonreduced kidney function (eGFR ≥ 60 ml/min/1.73 m 2 ).…”

Section: Discussionsupporting

confidence: 62%

“…Here, we used two different approaches. First, we analyzed eGFR as a dichotomized condition at baseline, considering patients with eGFR < 60 ml/min/1.73 m 2 as having impaired kidney function [2][3][4].…”

Section: Outcomes and Exposuresmentioning

confidence: 99%

“…Patients with chronic kidney disease (CKD) are at higher risk for stroke than patients with normal kidney function, as patients with ischemic stroke and CKD share the same cardiovascular risk factors [1,2]. Moreover, stroke patients with impaired kidney function have a higher risk of recurrent vascular events and death than patients with normal kidney function [3,4], as atrial fibrillation [5], higher lipoprotein (a) levels [6], and symptomatic intracranial bleeding after intravenous thrombolysis for acute stroke [7] are observed more often in patients with CKD.…”

Section: Introductionmentioning

confidence: 99%

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Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack

Tütüncü

Olma

Kunze

et al. 2022

Euro J of Neurology

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Background and purpose Impaired kidney function is associated with an increased risk of vascular events in acute stroke patients, when assessed by single measurements of estimated glomerular filtration rate (eGFR). It is unknown whether repeated measurements provide additional information for risk prediction. Methods The MonDAFIS (Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke) study randomly assigned 3465 acute ischemic stroke patients to either standard procedures or an additive Holter electrocardiogram. Baseline eGFR (CKD‐EPI formula) were dichotomized into values of < versus ≥60 ml/min/1.73 m2. eGFR dynamics were classified based on two in‐hospital values as “stable normal” (≥60 ml/min/1.73 m2), “increasing” (by at least 15% from baseline, second value ≥ 60 ml/min/1.73 m2), “decreasing” (by at least 15% from baseline of ≥60 ml/min/1.73 m2), and “stable decreased” (<60 ml/min/1.73 m2). The composite endpoint (stroke, major bleeding, myocardial infarction, all‐cause death) was assessed after 24 months. We estimated hazard ratios in confounder‐adjusted models. Results Estimated glomerular filtration rate at baseline was available in 2947 and a second value in 1623 patients. After adjusting for age, stroke severity, cardiovascular risk factors, and randomization, eGFR < 60 ml/min/1.73 m2 at baseline (hazard ratio [HR] = 2.2, 95% confidence interval [CI] = 1.40–3.54) as well as decreasing (HR = 1.79, 95% CI = 1.07–2.99) and stable decreased eGFR (HR = 1.64, 95% CI = 1.20–2.24) were independently associated with the composite endpoint. In addition, eGFR < 60 ml/min/1.732 at baseline (HR = 3.02, 95% CI = 1.51–6.10) and decreasing eGFR were associated with all‐cause death (HR = 3.12, 95% CI = 1.63–5.98). Conclusions In addition to patients with low eGFR levels at baseline, also those with decreasing eGFR have increased risk for vascular events and death; hence, repeated estimates of eGFR might add relevant information to risk prediction.

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Section: Discussionsupporting

confidence: 62%

Section: Outcomes and Exposuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack

Tütüncü

Olma

Kunze

et al. 2022

Euro J of Neurology

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“…Chronic kidney disease (CKD) is strongly associated with the full spectrum of cerebrovascular disease, including ischemic and hemorrhagic stroke, small vessel disease, and vascular cognitive impairment [ 24 ]. Dad and Weiner found that chronic kidney disease is an independent risk factor for both hemorrhagic stroke and ischemic stroke subtypes.…”

Section: Discussionmentioning

confidence: 99%

A Study on the Clinical Profiles of Patients With Cerebrovascular Accident (Stroke) in a Tertiary Care Hospital in Jharkhand

Kumar¹,

Kumar²,

Saroj³

et al. 2023

Cureus

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Introduction Stroke is a devastating and disabling cerebrovascular disease with a significant amount of residual deficit. The prevalence of stroke is in a rising trend in India. Larger studies are needed for the evaluation of risk factors. Material and methods This cross-sectional study aimed to assess the clinical profile of patients with stroke. The demographic details of the patients were taken, comorbidities were noted, and laboratory tests were done. Observation The most common age group who presented with stroke was 61-80 years, followed by 41-60 years, comprising 47% and 46%, respectively. Ischemic stroke was more common (60%) than hemorrhagic stroke (40%). Male patients were more than female patients. Alcohol, smoking, hypertension, diabetes, anemia, and proteinuria were present in the study group. Conclusion Regular evaluation of blood pressure, blood sugar, lipid profile, and proteinuria should be routinely done in patients with diabetes and hypertension who are more than 40 years old.

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“…Chronic kidney disease is associated with increased presence of cerebral microbleeds, white matter hyperintensities, and silent brain infarctions 16,17 . The complex relationship between chronic kidney disease, hypertension, cognitive impairment, and CSVD has been explored in a number of studies 16,18,19 …”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Diagnosis and Management of Cerebral Small Vessel Disease

Sharrief¹

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVECerebral small vessel disease (CSVD) is a common neurologic condition that contributes to considerable mortality and disability because of its impact on ischemic and hemorrhagic stroke risk and dementia. While attributes of the disease have been recognized for over two centuries, gaps in knowledge remain related to its prevention and management. The purpose of this review is to provide an overview of the current state of knowledge for CSVD.LATEST DEVELOPMENTSCSVD can be recognized by well-defined radiographic criteria, but the pathogenic mechanism behind the disease is unclear. Hypertension control remains the best-known strategy for stroke prevention in patients with CSVD, and recent guidelines provide a long-term blood pressure target of less than 130/80 mm Hg for patients with ischemic and hemorrhagic stroke, including those with stroke related to CSVD. Cerebral amyloid angiopathy is the second leading cause of intracerebral hemorrhage and may be increasingly recognized because of newer, more sensitive imaging modalities. Transient focal neurologic episodes is a relatively new term used to describe “amyloid spells.” Guidance on distinguishing these events from seizures and transient ischemic attacks has been published.ESSENTIAL POINTSCSVD is prevalent and will likely be encountered by all neurologists in clinical practice. It is important for neurologists to be able to recognize CSVD, both radiographically and clinically, and to counsel patients on the prevention of disease progression. Blood pressure control is especially relevant, and strategies are needed to improve blood pressure control for primary and secondary stroke prevention in patients with CSVD.

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Stroke and Chronic Kidney Disease

Cited by 8 publications

References 0 publications

Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack

Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack

A Study on the Clinical Profiles of Patients With Cerebrovascular Accident (Stroke) in a Tertiary Care Hospital in Jharkhand

Diagnosis and Management of Cerebral Small Vessel Disease

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