Thrombolysis in chinese ischemic stroke patients with renal dysfunction

Area of Science:

• Neurology
• Nephrology
• Cardiovascular Medicine

Background:

• Conflicting data exist on renal function's impact on stroke outcomes after thrombolysis.
• Investigating renal dysfunction in Chinese ischemic stroke patients receiving thrombolytic therapy is crucial.

Purpose of the Study:

• To determine if renal dysfunction affects clinical outcomes in Chinese ischemic stroke patients treated with thrombolysis.
• To analyze the relationship between estimated glomerular filtration rate (eGFR) and outcomes such as functional independence, early neurological improvement, symptomatic intracerebral hemorrhage, and mortality.

Main Methods:

• Study included Chinese patients treated with intravenous thrombolytic therapy for acute ischemic stroke.
• Renal dysfunction defined as eGFR <90 ml/min/1.73 m(2).
• Primary outcome: modified Rankin Scale (mRS) 0-2 at 3 months; secondary outcomes: National Institute of Health Stroke Scale (NIHSS) improvement, symptomatic intracerebral hemorrhage (ICH), and 30-day mortality.

Main Results:

• 199 patients recruited; 51.3% had renal dysfunction.
• No significant differences in functional independence, NIHSS improvement, or 30-day mortality between groups.
• Multivariate analysis indicated eGFR was not an independent risk factor for symptomatic ICH.

Conclusions:

• Renal dysfunction in Chinese ischemic stroke patients undergoing thrombolytic therapy did not lead to poorer clinical outcomes.
• Clinical outcomes were comparable to patients with normal renal function.
• Renal function status may not be a critical determinant for thrombolytic therapy effectiveness in this cohort.