Stroke in chronic kidney disease

Krishna, P Rama; Naresh, Sriram; Krishna, G S R; Lakshmi, AY; Vengamma, B; Kumar, V Siva

doi:10.4103/0971-4065.50672

Cited by 18 publications

(13 citation statements)

References 22 publications

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“…Similarly, laboratory results that might reflect impaired kidney function, such as creatinine, urea nitrogen, and potassium, are also positively correlated with stroke chance. This also agrees with previous work showing that patients with Chronic Kidney Disease are associated with a higher risk of stroke [ 36 ].…”

Section: Discussionsupporting

confidence: 93%

Laboratory tests as short-term correlates of stroke

et al. 2016

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BackgroundThe widespread adoption of electronic health records provides new opportunities to better predict which patients are likely to suffer a stroke. Using electronic health records, we assessed the correlation of different laboratory tests to future occurrences of a stroke.MethodsWe examined the electronic health records of 2.4 million people over a two year time span. These records contained 26,964 diagnoses of stroke. Using Cox regression analysis, we measured whether any one of 1796 different laboratory tests were effectively correlated with a future diagnosis of stroke.ResultsWe identified 38 different laboratory tests that had significant short-term (two year) prognostic value for a future diagnosis of stroke. For each of the 38 laboratory tests we also compiled the Kaplan-Meier survival curve, and relative risk ratio that the test confers.ConclusionSeveral dozen laboratory tests are effective short-term correlates of stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0619-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Laboratory tests as short-term correlates of stroke

et al. 2016

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“…The high risk of bleeding in CKD patients can be partially attributed to disturbances in the coagulation system, coupled with an altered response to medications 8) . Therefore, it could be identified as a significant risk factor for increased morbidity and mortality after stroke 11) .…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

Kim

Shin

Park

et al. 2013

J Korean Neurosurg Soc

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ObjectiveWe conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis.MethodsFrom January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis.ResultsThe mean GCS score on admission was 9.4±4.4 and the mean mRS was 4.3±1.8. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome.ConclusionNeurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

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“…This is in contrast to the general population where obesity confers a higher stroke risk. Low albumin affecting erythrocyte deformability and endothelial dysfunction may well explain the increased stroke risk in malnourished patients (23,24). The observation of low albumin in our study concurs with the available literature and emphasizes the importance of maintaining good nutrition in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Outcome of Intracranial Bleeding in Patients Undergoing Hemodialysis at a Tertiary Hospital

Deshpande

2020

Nephro-Urol Mon

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Background: Stroke is one of the leading causes of mortality in the dialysis population. Although there is plenty of literature available for cardiovascular risk factors in dialysis patients, very few studies have focused on cerebrovascular events and Indian data are sparse. Objectives: This study was undertaken to address some of these shortcomings. Methods: This is a matched cohort study. There were 30 cases with intracranial bleeding (ICB) in hemodialysis patients whose clinical profiles were compared with 60 matched controls with no ICB and the data was analyzed. Results: The common cause of chronic kidney disease (CKD) was diabetes. Event BP was high but not significantly. Serum albumin values were lower in patients than in controls (2.65 vs. 3.15 g/dL). The common site of bleeding in our study was intraparenchymal (60%), followed by subdural hematoma (30%). Mortality was 76.7% in one month. Although the incidence of bleeding was slightly more in the thrice-weekly dialysis group, the difference was not significant. The diabetic status of ICB patients was poorly controlled. Conclusions: Hemodialysis patients have multiple risk factors for ICB and low serum albumin could be one of them. These patients have high short-term mortality (76.7%). There was a slightly increased incidence of ICB in patients who underwent thrice-weekly dialysis and those with poor glycemic control. This needs a systemic study with larger sample size and longer follow-up.The present study focused on intracranial bleeding (ICB) in dialysis patients by analyzing the clinical profile, various associated risk factors, and the impact of ICB on short-term patient survival. MethodsThis case-control study was undertaken at St. John Medical College, Bangalore, India, over a span of three years. This tertiary care hospital caters to people across all socioeconomic strata. The study included patients with CKD on long-term maintenance hemodialysis at St. Johns who either suffered ICB in the hospital or came to the emergency with the event. Those with ischemic stroke were excluded. We recorded clinical features such as vital signs, Glasgow coma score, comorbid diseases, viral serology, hemogram, blood biochemistry including liver and renal panel, and coagulation profile. The CT/MRI reports were noted for the site of ICB, the size of bleeding, and intraventricular

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Stroke in chronic kidney disease

Cited by 18 publications

References 22 publications

Laboratory tests as short-term correlates of stroke

Laboratory tests as short-term correlates of stroke

Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

Clinical Profile and Outcome of Intracranial Bleeding in Patients Undergoing Hemodialysis at a Tertiary Hospital

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