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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
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Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction
Xu Yan1,2, Huan Chen3, Xiuli Shang4
1Department of Neurology, The First Affiliated Hospital of China Medical University, 92 North Second Rd, Shenyang, 110001, Liaoning Province, China.
Scientific Reports
|March 24, 2024
Summary
Lower estimated glomerular filtration rate (eGFR) after mild stroke is linked to endothelial dysfunction (ED). ED may increase the risk of post-stroke cognitive impairment (PSCI) within three months.
Area of Science:
- Neurology
- Nephrology
- Cardiology
Background:
- Post-stroke cognitive impairment (PSCI) is common after mild stroke (MIS), with uncertain risk factors.
- Increased cystatin C (CysC) levels suggest reduced glomerular filtration rate (GFR) and renal impairment.
- Endothelial dysfunction (ED) is implicated in both renal and cognitive impairments.
Purpose of the Study:
- To investigate if lower GFR, estimated by CysC, contributes to PSCI after MIS.
- To determine the role of ED in the relationship between renal function and PSCI.
Main Methods:
- Prospective observational study of 256 MIS patients.
- Renal function assessed by eGFRcys; endothelial function by reactive hyperemia index (RHI).
- Cognitive function evaluated using MoCA scores at baseline and 3 months.
Main Results:
- Lower eGFRcys correlated significantly with ED (p < 0.001).
- ED was present in 55.1% of patients.
- RHI was an independent predictor of PSCI (p < 0.05), with an optimal cutoff of 1.655 (AUC=0.724).
- PSCI occurred in 58.6% of patients at 3 months.
Conclusions:
- Reduced eGFRcys is associated with ED in MIS patients.
- ED appears to mediate the increased incidence of PSCI at 3 months post-MIS.
