Type

Journal Article

Authors

Peter J Kelly
Yvonne O'Meara
Sean Murphy
David Williams
Killian O' Rourke
Eamon Dolan
Joseph Duggan
Lorraine Kyne
Gillian Horgan
Danielle Ní Chróinín
and 4 others

Subjects

Veterinary

Topics
renal disease north dublin proportional hazards survival analysis ischemic attack transient kaplan meier glomerular filtration rate chronic kidney disease

Renal dysfunction and chronic kidney disease in ischemic stroke and transient ischemic attack: A population-based study. (2017)

Abstract Background and purpose The prevalence of chronic kidney disease (estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m(2) for ≥3 months, chronic kidney disease (CKD)) in ischemic stroke and transient ischemic attack (TIA) is unknown, as estimates have been based on single-point estimates of renal function. Studies investigating the effect of renal dysfunction (eGFR < 60 mL/min per 1.73 m(2), renal dysfunction) on post-stroke outcomes are limited to hospitalized cohorts and have provided conflicting results. Methods We investigated rates, determinants and outcomes of renal dysfunction in ischemic stroke and TIA in the North Dublin Population Stroke Study. We also investigate the persistence of renal dysfunction in 90-day survivors to determine the prevalence of CKD. Ascertainment included hot and cold pursuit using multiple overlapping sources. Survival analysis was performed using Kaplan-Meier survival curves and Cox proportional hazards modeling. Results In 547 patients (ischemic stroke in 76.4%, TIA in 23.6%), the mean eGFR at presentation was 63.7 mL/min/1.73 m(2) (SD 22.1). Renal dysfunction was observed in 44.6% (244/547). Among 90-day survivors, 31.2% (139/446) met criteria for CKD. After adjusting for age and stroke severity, eGFR < 45 mL/min/1.73 m(2) (hazard ratio 2.53, p = 0.01) independently predicted 28-day fatality but not at two years. Poor post-stroke functional outcome (Modified Rankin Scale 3-5) at two years was more common in those with renal dysfunction (52.5% vs. 20.6%, p < 0.001). After adjusting for age, stroke severity and pre-stroke disability, renal dysfunction (OR 2.17, p = 0.04) predicted poor functional outcome. Conclusion Renal dysfunction and CKD are common in ischemic stroke and TIA. Renal dysfunction is associated with considerable post-stroke morbidity and mortality. Further studies are needed to investigate if modifiable mechanisms underlie these associations.
Collections Ireland -> IT Blanchardstown -> PubMed

Full list of authors on original publication

Peter J Kelly, Yvonne O'Meara, Sean Murphy, David Williams, Killian O' Rourke, Eamon Dolan, Joseph Duggan, Lorraine Kyne, Gillian Horgan, Danielle Ní Chróinín and 4 others

Experts in our system

1
Peter J Kelly
University College Dublin
Total Publications: 35
 
2
Sean Murphy
University College Dublin
Total Publications: 35
 
3
David Williams
Royal College of Surgeons in Ireland
Total Publications: 82
 
4
Eamon Dolan
IT Blanchardstown
Total Publications: 42
 
5
Joseph Duggan
University College Dublin
Total Publications: 11
 
6
Lorraine Kyne
University College Dublin
Total Publications: 25
 
7
Gillian Horgan
University College Dublin
Total Publications: 11
 
8
Danielle Ní Chróinín
University College Dublin
Total Publications: 6