Early renal dysfunction and fibroblast growth factor-23 in patients with small vessel disease-related stroke

Fandler‐Höfler, Simon; Enzinger, Christian; Kneihsl, Markus; Pinter, Daniela; Eppinger, Sebastian; Obermayer–Pietsch, Barbara; Goritschan, Anna; Hafner-Gießauf, Hildegard; Rosenkranz, Alexander R.; Fazekas, Franz; Gattringer, Thomas

doi:10.1038/s41598-019-51965-5

Cited by 8 publications

(5 citation statements)

References 31 publications

(47 reference statements)

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“…Besides a thorough clinical neurological assessment and cerebrovascular workup (duplex sonography of extra- and intracranial brain-supplying arteries, echocardiography, and 24-h Holter ECG), patients underwent blood sampling and brain MRI at baseline and at 3 and 15 months after their index event. Detailed description of the study cohort has been reported elsewhere [ 8 , 9 ].…”

Section: Methodsmentioning

confidence: 99%

Serum glial fibrillary acidic protein is sensitive to acute but not chronic tissue damage in cerebral small vessel disease

et al. 2022

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Background Serum glial fibrillary acidic protein (sGFAP) has been proposed as a biomarker in various neurological diseases but has not yet been systematically investigated in patients with cerebral small vessel disease (CSVD). We explored whether sGFAP levels are increased in stroke patients with MRI-confirmed recent small subcortical infarcts (RSSI) and analyzed the subsequent course and determinants of sGFAP longitudinally. Methods In a prospectively-collected cohort of stroke patients with a single RSSI (n = 101, mean age: 61 years, 73% men), we analyzed brain MRI and sGFAP using a SIMOA assay at baseline and at 3- and 15-months post-stroke. Community-dwelling age- and sex-matched individuals (n = 51) served as controls. Results RSSI patients had higher baseline sGFAP levels compared to controls (median: 187.4 vs. 118.3 pg/ml, p < 0.001), with no influence of the time from stroke symptom onset to baseline blood sampling (median 5 days, range 1–13). At the 3- and 15-months follow-up, sGFAP returned to control levels. While baseline sGFAP correlated with larger infarct size (rs = 0.28, p = 0.01), neither baseline nor follow-up sGFAP levels were associated with chronic CSVD-related lesions (white matter hyperintensities, lacunes, microbleeds) after adjusting for age, sex and hypertension. Furthermore, sGFAP levels did not relate to the occurrence of new vascular brain lesions on follow-up MRI. Conclusions sGFAP is increased in patients with CSVD-related stroke and correlates with the size of the RSSI. However, sGFAP levels were not related to chronic neuroimaging features or progression of CSVD, suggesting that sGFAP is sensitive to acute but not chronic cerebrovascular tissue changes in this condition.

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Section: Methodsmentioning

confidence: 99%

Serum glial fibrillary acidic protein is sensitive to acute but not chronic tissue damage in cerebral small vessel disease

et al. 2022

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“…There are many studies about the relationship between kidney injury and the occurrence of IS [22][23][24][25][26]. Few scholars believe that only IS can induce kidney injury [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Few scholars believe that only IS can induce kidney injury [23,24]. Many scholars have con rmed that not only IS can induce kidney injury, but also kidney injury can induce IS [25][26][27]. The structure and function of the microvascular system of the brain are similar to that of the kidney.…”

Section: Discussionmentioning

confidence: 99%

Differential Performance of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C to Predict Ischemic Stroke

Peng

Chen

et al. 2021

Preprint

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Objective Both cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL) are markers of kidney injury and may also be marker candidates for neuroinflammation. The aim of this article is to explore the relationship between kidney injury and ischemic stroke (IS).Methods 498 IS patients were enrolled, and 173 IS-related disease control (DC) patients and 293 healthy control (HC) subjects were randomly selected. We analyzed the relationship between the levels of serum kidney function markers (including NGAL, Cre, Ure, CysC and eGFR) and the occurrence of IS.Results When they were admitted to the hospital, the NGAL level of patients with first-onset IS was higher than that of both HC group (z=5.964, P<0.001) and DC (z=12.191, P<0.001); The level of CysC of them was higher than that of HC group (z=5.762, P<0.001), and was the similar with that of DC group (z=1.663, P=0.289). The partial correlation coefficient between NGAL and the occurrence of IS was the highest (rp=0.341, P<0.001) in IS patients with normal kidney function. However, the partial correlation coefficient between CysC and IS was the highest (rp=0.460) , P<0.001) in IS patients with chronic kidney disease (CKD). For patients with normal kidney function, only NGAL was a risk factor for IS [OR(95%CI)=6.54(3.75,11.41)], and had the certain predictive performance AUC=0.734(z=12.928, P<0.001). However, for CKD patients, CysC has better predictive performance for IS occurrence AUC=0.835 (z=11.343, P<0.001) and risk assessment ability [OR(95%CI)=5.97(2.45, 14.56)] than NGAL.Conclusion IS is related to kidney injury and neuroinflammation. NGAL and CysC are suitable for IS prediction in patients with normal kidney function and CKD, respectively. Researchers should pay attention to the changes of NGAL and CysC for the prevention and treatment of stroke in these two types of patients, respectively.

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“…In addition, our research shows that hypertensive patients with CKD, diabetes, stroke, or gout were associated with kidney function decline, which is consistent with previous studies. Diabetes mellitus, CKD, stroke, and gout are independent risk factors for renal disease [35,[44][45][46].…”

Section: Discussionmentioning

confidence: 99%

High Level of Physical Activity Reduces the Risk of Renal Progression in Hypertensive Patients

Chang

Lyu

Lin

et al. 2020

IJERPH

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Physical activity has long been associated with chronic diseases. However, the association between physical activity and renal progression in hypertensive patients remains unclear. This study investigated the relationship between the level of physical activity and renal function in hypertensive patients. We analyzed 3543 patients with hypertension. Data on patients’ demographic characteristics, comorbidities, physical activity, and lifestyle characteristics were collected via questionnaires. An estimated glomerular filtration rate (eGFR) that was reduced by more than 25% from the baseline eGFR was defined as renal progression. This study divided physical activity into three levels (low, moderate, and high) based on their metabolic equivalent of tasks (METs) levels. The mean age was 63.32 ± 12.29 years. After we adjusted for covariates, renal progression was significantly higher among patients with low levels of physical activity (odds ratio (OR), 1.39; 95% confidence interval (CI), 1.01–1.90)) and moderate levels of physical activity (OR, 1.39; 95% CI, 1.04–1.86) than among patients with high levels of physical activity. We found a significant association between physical activity and renal progression in hypertensive patients, especially in elderly patients and men. Therefore, to reduce the risk of renal progression, we recommend that clinicians should encourage patients to improve their physical activity.

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Early renal dysfunction and fibroblast growth factor-23 in patients with small vessel disease-related stroke

Cited by 8 publications

References 31 publications

Serum glial fibrillary acidic protein is sensitive to acute but not chronic tissue damage in cerebral small vessel disease

Serum glial fibrillary acidic protein is sensitive to acute but not chronic tissue damage in cerebral small vessel disease

Differential Performance of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C to Predict Ischemic Stroke

High Level of Physical Activity Reduces the Risk of Renal Progression in Hypertensive Patients

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