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Updated: Jun 27, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Inflammation and Adverse Outcomes in Patients With Acute Ischemic Stroke With and Without Chronic Kidney Disease
Xiaoyu Wang1, Yuesong Pan1,2, Runhua Zhang1,2
1Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing China.
Insights
Inflammation markers predict adverse outcomes in acute ischemic stroke (AIS) patients. This association was significant in those without chronic kidney disease (CKD), suggesting targeted risk assessment.
Area of Science:
- Clinical Medicine
- Cardiovascular Research
- Nephrology
Background:
- Elevated white blood cell count, fibrinogen, and low albumin indicate systemic inflammation, hypercoagulability, and poor nutrition.
- The impact of inflammatory markers on cardiovascular disease in chronic kidney disease (CKD) patients remains unclear.
- Investigating inflammation's role in acute ischemic stroke (AIS) outcomes, and its interaction with CKD is crucial.
Purpose of the Study:
- To explore the association between inflammation and adverse outcomes in AIS patients.
- To determine if the presence of CKD modifies the relationship between inflammation and adverse outcomes in AIS.
Main Methods:
- Utilized data from the Third China National Stroke Registry.
- Defined inflammation as the worst quartile of white blood cell count, fibrinogen, or albumin.
- Analyzed associations between inflammation and poor functional outcome, stroke recurrence, and combined vascular events at 1 year in 8493 AIS patients.
Main Results:
- Inflammation was associated with increased odds of poor functional outcomes (OR 1.58), stroke recurrence (OR 1.25), and combined vascular events (OR 1.25) in AIS patients.
- The association between inflammation and adverse outcomes was observed primarily in AIS patients without CKD.
- No statistically significant interaction was found between CKD and inflammation regarding adverse outcomes (P > 0.05).
Conclusions:
- Inflammation, defined by specific biomarkers, is linked to adverse 1-year outcomes in AIS patients.
- Routine assessment of these inflammatory markers may aid risk stratification for AIS patients, particularly those without CKD.
- Clinical evaluation of inflammation markers can support treatment decisions for AIS patients, especially in the absence of CKD.
Background:
Elevated white blood cell count, fibrinogen levels, and lower levels of albumin signify higher systemic inflammatory response, hypercoagulable state, and poorer nutritional status, respectively. However, a consistent conclusion could not be drawn on whether the association between inflammatory markers and cardiovascular disease was affected by the presence of chronic kidney disease (CKD). We aimed to explore the association between inflammation and adverse outcomes in patients with acute ischemic stroke (AIS), as well as whether this association differs due to the presence of CKD.
Methods And Results:
This research was based on the Third China National Stroke Registry. The main adverse outcomes were poor functional outcome, stroke recurrence, and combined vascular event after 1 year. Inflammation was defined as the worst quartile of at least 2 of the aforementioned 3 markers. Finally, 8493 patients with AIS were enrolled in this study. The adjusted odds ratios/hazard ratios and 95% CIs of inflammation were 1.58 (1.34-1.86) for poor functional outcomes, 1.25 (1.06-1.47) for stroke recurrence, and 1.25 (1.06-1.46) for combined vascular event. The association between inflammation and adverse outcomes existed only in patients with AIS without CKD, although the interaction between CKD and inflammation was not statistically significant. (P for interaction >0.05).
Conclusions:
Inflammation, which was defined as a combination of fibrinogen, white blood cell count, and albumin, was associated with all 1-year adverse outcomes among patients with AIS. Routine assessment of these biomarkers could become a potential part of the clinical evaluation for patients with AIS, especially those without CKD, aiding clinicians in risk stratification and treatment decision-making.
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