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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Renal dysfunction and chronic kidney disease in ischemic stroke and transient ischemic attack: A population-based
Derek Hayden1, Christine McCarthy1, Layan Akijian1
11 Neurovascular Unit For Translational and Therapeutics Research, University College Dublin/Dublin Academic Medical Centre, Mater Misericordiae University Hospital, Dublin, Ireland.
Summary
Renal dysfunction and chronic kidney disease (CKD) are common in ischemic stroke and TIA patients, significantly increasing post-stroke mortality and poor functional outcomes. Further research is needed to explore potential modifiable mechanisms.
Area of Science:
- Nephrology
- Neurology
- Epidemiology
Background:
- The prevalence of chronic kidney disease (CKD) in ischemic stroke and transient ischemic attack (TIA) patients is not well-established.
- Previous studies on renal dysfunction and post-stroke outcomes are limited to hospitalized cohorts and have yielded conflicting results.
Purpose of the Study:
- To investigate the rates, determinants, and outcomes of renal dysfunction in ischemic stroke and TIA patients.
- To determine the prevalence of CKD by assessing the persistence of renal dysfunction in 90-day survivors.
Main Methods:
- Utilized the North Dublin Population Stroke Study data, including hot and cold pursuit ascertainment.
- Employed survival analysis using Kaplan-Meier curves and Cox proportional hazards modeling.
- Assessed renal dysfunction using estimated glomerular filtration rate (eGFR <60 mL/min per 1.73 m²).
Main Results:
- Renal dysfunction was observed in 44.6% of 547 patients; 31.2% of 90-day survivors met CKD criteria.
- An eGFR <45 mL/min per 1.73 m² independently predicted 28-day fatality (HR 2.53, p=0.01).
- Renal dysfunction predicted poor functional outcomes at two years (OR 2.17, p=0.04) and was associated with higher morbidity (52.5% vs. 20.6%, p<0.001).
Conclusions:
- Renal dysfunction and CKD are prevalent in ischemic stroke and TIA.
- Renal dysfunction is linked to significant post-stroke morbidity and mortality.
- Further research is warranted to explore potentially modifiable mechanisms underlying these associations.
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