Highlights
- •This study aims to evaluate the short-term (1-month) and long-term (1-year) mortality for patients with acute ischemic stroke by the glomerular filtration rate (eGFR) levels measured at admission: ≥ 90, 60–89, 30–59, 15–29, and <15 mL/min/1.73 m2 or on dialysis.
- •Patients with reduced eGFR were at higher risk of dying either at short- or long-term in a graded relationship.
Abstract
Background and aims
Renal dysfunction is a potent risk factor for cardiovascular diseases, including stroke.
This study aimed to evaluate the impact of admission estimated glomerular filtration
rate (eGFR) levels on short-term (1-month) and long-term (1-year) mortality in patients
with acute ischemic stroke.
Methods
From the Taiwan Stroke Registry data, we classified ischemic stroke patients, identified
from April 2006 to December 2015, into 5 groups by eGFR at admission: ≥ 90, 60–89,
30–59, 15–29, and <15 mL/min/1.73 m2 or on dialysis. Risks of 1-month mortality and 1-year mortality after ischemic stroke
were investigated by the eGFR level.
Results
Among 52,732 ischemic stroke patients, 1480 died within one month. The 1-month mortality
rate was over 5-fold greater in patients with eGFR <15 mL/min/1.73 m2 or dialysis than in patients with eGFR ≥90 mL/min/1.73 m2 (2.88 versus 0.56 per 1000 person-days). The adjusted hazard ratio (HR) of 1-month mortality increased
from 1.31 (95% CI = 1.08–1.59) for patients with eGFR 60–89 mL/min/1.73 m2 to 2.33 (95% CI = 1.80–3.02) for patients with eGFR < 15 mL/min/1.73 m2 or on dialysis. 3226 patients died within one year. The adjusted HR of mortality
increased from 1.38 (95% CI = 1.21–1.59) for patients with eGFR 60–89 mL/min/1.73 m2 to 2.60 (95% CI 2.18–3.10) for patients with eGFR < 15 mL/min/1.73 m2 or on dialysis, compared to patients with eGFR ≥ 90 mL/min/1.73 m2.
Conclusions
After acute ischemic stroke, patients with reduced eGFR are at elevated risks of short-term
and long-term deaths in a graded relationship.
Keywords
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Article info
Publication history
Published online: December 11, 2017
Accepted:
November 29,
2017
Received in revised form:
October 26,
2017
Received:
August 12,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
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- Stroke outcome is associated with baseline renal function: A risk factor that matters!AtherosclerosisVol. 269
- PreviewKidney disease and more specifically chronic kidney disease (CKD) prevalence is on the rise and it is estimated that the prevalence of CKD is almost 11–13% in the world [1]. During the last twenty years, a number of studies have shown that patients with CKD have a higher risk for cardiovascular events including stroke and myocardial infarction [2–5]. Furthermore, CKD has been associated with an increased risk for all mortality and cardiovascular (CV) mortality [6]. In light of this, it is not surprising that in this issue of Atherosclerosis Wang et al.
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