Association of Glomerular Filtration Rate With Outcomes of Acute Stroke in Type 2 Diabetic Patients: Results From the China National Stroke Registry

Luo, Yang; Wang, Xianwei; Wang, Yilong; Wang, Chunxue; Wang, Hai-Chen; Wang, David; Liu, Liping; Jia, Qi; Liu, Gaifen; Zhao, Xingquan

doi:10.2337/dc13-1931

Cited by 37 publications

(40 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Putaala et al reported that a high eGFR (≥120 mL/min/1.73 m 2 ) was significantly related to higher risk of all‐cause mortality after first ever ischaemic stroke in young patients (aged 15–49 years); importantly, the association remained significant after adjustment for age, gender, traditional risk factors, stroke severity and stroke subtype . Similar findings were observed in another study: a significant association between high eGFR (≥120 mL/min/1.73 m 2 ) and increased risk of all‐cause mortality in patients with type 2 diabetes followed a first stroke . A study including more than 4000 patients with type 1 diabetes showed that high eGFR correlated to increased mortality risk .…”

Section: Resultssupporting

confidence: 65%

“…Some of the studies abstained from using the terminology “hyperfiltration”, considering that high eGFR values may not be an accurate indication of true RHF, and used instead the terminology “high/highest GFR quartiles/groups” . Several authors never used the “hyperfiltration” term in their studies and discarded their findings of high GFR merely as a “false overestimation of GFR by creatinine‐based equations” .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Renal hyperfiltration defined by high estimated glomerular filtration rate: A risk factor for cardiovascular disease and mortality

Kanbay

Ertuğlu

Afsar

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Renal hyperfiltration, defined as an increased glomerular filtration rate above normal values, is associated with early phases of kidney disease in the setting of various conditions such as obesity and diabetes. Although it is recognized that glomerular hyperfiltration, that is, increased filtration per nephron unit (usually studied at low glomerular filtration levels and often referred to as single nephron hyperfiltration), is a risk factor for the progression of chronic kidney disease, the implications of having renal hyperfiltration for cardiovascular disease and mortality risk are incompletely understood. Recent evidence from diverse populations, including healthy individuals and patients with diabetes or established cardiovascular disease, suggests that renal hyperfiltration is associated with a higher risk of cardiovascular disease and all‐cause mortality. In this review, we critically summarize the existing studies, discuss possible mechanisms, and describe the remaining gaps in our knowledge regarding the association of renal hyperfiltration with cardiovascular disease and mortality risk.

show abstract

Section: Resultssupporting

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Renal hyperfiltration defined by high estimated glomerular filtration rate: A risk factor for cardiovascular disease and mortality

Kanbay

Ertuğlu

Afsar

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…22,25 An ordinal score ranging from 0 to 4 was constructed to reflect the total cSVD burden. One point was awarded for each of the following items: moderate to extensive (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) …”

Section: Cerebral Small Vessel Disease Burden Scalementioning

confidence: 99%

“…However, the CKD-EPI equation is also widely accepted as a valid surrogate of kidney function for the Asian population. 17,18 Third, given the convenience of clinical use, WMH were rated using a semiquantitive rating scale, although this scale is widely used with a good sensitivity and reliability and fits for the existing cSVD burden scale. Fourth, our patient selection favors less disabled patients, able to undergo MRI.…”

Section: August 2015mentioning

confidence: 99%

Chronic Kidney Disease in Patients With Lacunar Stroke

Xiao

Lan

Sun

et al. 2015

Stroke

View full text Add to dashboard Cite

Background and Purpose-The relationship between chronic kidney disease and cerebral small vessel disease (cSVD), especially enlarged perivascular spaces (EPVS), has not been fully understood. This study aimed to investigate the association of chronic kidney disease and EPVS, as well as the total burden of cSVD on magnetic resonance imaging, expressed by the simultaneous presence of multiple markers of cSVD, among patients with first-ever lacunar stroke. Methods-Four hundred and thirteen consecutive patients were prospectively enrolled. Centrum semiovale and basal ganglia EPVS on T2-weighted magnetic resonance imaging, as well as other imaging markers of cSVD, including lacune, white matter lesions, and cerebral microbleeds, were rated using validated scales. Chronic kidney disease was defined as either reduced estimated glomerular filtration rate or the presence of proteinuria. Results-After adjustments for potential confounders by logistic regression, proteinuria and impaired estimated glomerular filtration rate were correlated with the severity of EPVS in both centrum semiovale (odds ratio

show abstract

“…[1213] Renal function is closely linked to all-cause mortality and functional disabilities in patients with stroke. [141516] A severely decreased estimated glomerular filtration rate (eGFR) is a prognostic indicator of a poor outcome in stroke. [17] Heart rate variability (HRV) is a predictor of mortality in chronic kidney disease (CKD).…”

Section: Introductionmentioning

confidence: 99%

Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction

Wei

Zhao

et al. 2017

Chinese Medical Journal

View full text Add to dashboard Cite

Background:Renal function is associated with mortality and functional disabilities in stroke patients, and impaired autonomic function is common in stroke, but little is known regarding its effects on stroke patients with renal dysfunction. This study sought to evaluate the association between autonomic function and stroke in patients with renal dysfunction.Methods:This study comprised 232 patients with acute ischemic stroke consecutively enrolled from February 2013 to November 2014 at Guangdong Provincial Hospital of Chinese Medicine in China. All patients recruited underwent laboratory evaluation and 24 h Holter electrocardiography (ECG). Autonomic function was measured based on the heart rate variability (HRV) using 24 h Holter ECG. Renal damage was assessed through the estimated glomerular filtration rate (eGFR), and stroke severity was rated according to the National Institutes of Health Stroke Scale (NIHSS). The Barthel index and modified Rankin score were also determined following admission. All the clinical covariates that could potentially affect autonomic outcome variables were adjusted with linear regression.Results:In the patients with a mild or moderate decreased eGFR, the values for the standard deviation of the averaged normal-to-normal RR interval (SDANN) index (P = 0.022), very low frequency (VLF) (P = 0.043), low frequency (LF) (P = 0.023), and ratio of low-to-high frequency power (LF/HF) (P = 0.001) were significantly lower than those in the patients with a normal eGFR. A multinomial linear regression indicated that eGFR (t = 2.47, P = 0.014), gender (t = −3.60, P < 0.001), and a history of hypertension (t = −2.65, P = 0.008) were the risk factors of LF/HF; the NIHSS score (SDANN index: t = −3.83, P < 0.001; VLF: t = −3.07, P = 0.002; LF: t = −2.79, P = 0.006) and a history of diabetes (SDANN index: t = −3.58, P < 0.001; VLF: t = −2.54, P = 0.012; LF: t = −2.87, P = 0.004) were independent factors for the SDANN index, VLF, and LF; the Oxfordshire Community Stroke Project (t = −2.38, P = 0.018) was related to the SDANN index.Conclusions:Autonomic dysfunction is aggravated with the progression of eGFR stage in patients with acute ischemic stroke; the eGFR is an independent factor of LF/HF in the adjusted models. Stroke severity and a history of diabetes are more significantly associated with HRV in patients with acute ischemic stroke at different stages of renal dysfunction.

show abstract

Association of Glomerular Filtration Rate With Outcomes of Acute Stroke in Type 2 Diabetic Patients: Results From the China National Stroke Registry

Abstract: OBJECTIVEWe aim to explore whether a link exists between different levels of estimated glomerular filtration rate (eGFR) and poor outcomes of acute stroke in patients with type 2 diabetes.

Cited by 37 publications

References 26 publications

Renal hyperfiltration defined by high estimated glomerular filtration rate: A risk factor for cardiovascular disease and mortality

Renal hyperfiltration defined by high estimated glomerular filtration rate: A risk factor for cardiovascular disease and mortality

Chronic Kidney Disease in Patients With Lacunar Stroke

Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction

Contact Info

Product

Resources

About