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Renal dysfunction increases the risk of ischemic and hemorrhagic stroke in the general population

Martin J Holzmann1, Are Aastveit, Niklas Hammar

  • 1Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden. martin.holzmann@karolinska.se

Annals of Medicine
|May 27, 2011
PubMed

Insights

Chronic kidney disease (CKD) increases stroke risk. Even mild CKD elevates ischemic stroke risk, while severe CKD raises hemorrhagic stroke risk, particularly in women.

Area of Science:

  • Nephrology
  • Neurology
  • Epidemiology

Background:

  • The relationship between chronic kidney disease (CKD) and stroke subtypes remains incompletely understood, with prior research yielding inconsistent findings.
  • Assessing the impact of renal dysfunction on stroke incidence is crucial for public health.
  • Understanding gender-specific risks associated with CKD and stroke is essential.

Purpose of the Study:

  • To investigate the association between varying degrees of chronic kidney disease (CKD) and the risk of fatal or non-fatal ischemic and hemorrhagic strokes.
  • To analyze these associations separately for men and women.
  • To clarify the impact of decreased estimated glomerular filtration rate (eGFR) on stroke subtypes.

Main Methods:

  • A large-scale cohort study involving 539,287 Swedish adults with no prior history of stroke or myocardial infarction.
  • Estimated glomerular filtration rate (GFR) was calculated using the Mayo formula (GFR-Mayo).
  • Mild (60-90 mL/min/1.73 m²), moderate (30-60 mL/min/1.73 m²), and severe (<30 mL/min/1.73 m²) decreases in GFR were defined.

Main Results:

  • Over 12 years, 17,678 strokes occurred: 72% ischemic, 15% hemorrhagic, and 12% unspecified.
  • Decreased GFR-Mayo was associated with increased ischemic stroke risk across all severity levels in both genders.
  • Hemorrhagic stroke risk was elevated with decreased GFR-Mayo, particularly in women, with a significant association observed at all severity levels.

Conclusions:

  • Even mildly reduced GFR significantly increases the risk of ischemic stroke in the general population.
  • Severely decreased GFR is associated with an increased risk of hemorrhagic stroke.
  • While ischemic stroke risk is linked to reduced GFR in both genders, hemorrhagic stroke risk shows a stronger association with renal dysfunction specifically among women.
Abstract

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