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Published on: September 1, 2016
Stroke and renal dysfunction
Tanja Hojs Fabjan1, Radovan Hojs2
1Dept. of Neurology, University Clinical Centre Maribor, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Maribor, Slovenia.
Insights
Chronic kidney disease (CKD) significantly increases stroke risk, particularly in dialysis patients. Renal dysfunction in stroke patients is linked to higher mortality, highlighting the need for further research into effective treatments.
Area of Science:
- Neurology
- Nephrology
- Cardiovascular Medicine
Background:
- Stroke is a leading neurological disease with significant medical and social impact.
- Chronic kidney disease (CKD) is a global health issue associated with increased cardiovascular risks.
- The connection between CKD and cerebrovascular disease has gained increasing recognition.
Purpose of the Study:
- To review the association between chronic kidney disease and stroke.
- To highlight the increased stroke incidence and mortality in CKD patients.
- To discuss the prevalence and impact of renal dysfunction in stroke patients.
Main Methods:
- Literature review of studies examining the link between CKD and stroke.
- Analysis of data on stroke incidence in end-stage renal disease patients on hemodialysis.
- Examination of prevalence and mortality data for renal dysfunction in stroke populations.
Main Results:
- Patients on maintenance hemodialysis exhibit a substantially higher stroke incidence.
- Ischemic stroke constitutes approximately 70% of strokes in dialysis patients.
- Renal dysfunction is prevalent in stroke patients (up to 38%) and associated with increased mortality.
Conclusions:
- CKD is clearly associated with an increased risk of stroke, especially in high-risk individuals.
- Renal dysfunction is an independent predictor of mortality in stroke patients.
- Optimal stroke treatment strategies for patients with CKD remain to be determined.
Abstract:
Stroke is the most frequent neurological disease and represents a continuously evolving medical and social problem. Chronic kidney disease (CKD) is also an important worldwide public health problem. Renal dysfunction carries a substantial risk of cardiovascular morbidity and mortality and an independent, graded association between renal function and cardiovascular events was found. In the last 15years the link between CKD and cerebrovascular disease has become more apparent. Patients with end stage renal disease treated with maintenance hemodialysis have a much higher incidence of stroke than the general population and stroke is one of the major causes of death in these patients. Nowadays ischemic subtype of stroke is present in approximately 70% of dialysis patients. In population based studies conflicting results have been reported about the association between stroke and CKD before replacement therapy. However, in high risk patients, defined by the presence of either cardiovascular disease or cardiovascular risk factors, different stages of CKD are clearly associated with subsequent stroke. In patients with stroke the exact prevalence of renal dysfunction is not known. Reported prevalence from a few published studies is up to 38% and it is higher than that in age-matched control groups. Furthermore, in patients suffering from stroke renal dysfunction is associated with short and long term mortality. The most effective treatment of stroke in patients with CKD is not known and further studies are needed.
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