Serum uric acid, kidney function and acute ischemic stroke outcomes in elderly patients: a single-cohort, perspective study

Abstract

Chronic kidney disease and hyperuricemia have been associated to an increased risk and a worse prognosis in acute ischemic stroke. Several mechanisms, including platelet dysfunction, coagulation disorders, endothelial dysfunction, inflammation, and an increased risk of atrial fibrillation could be implicated. The role of serum uric acid in this setting is still object of debate. We enrolled all the consecutive patients admitted to our department for acute ischemic stroke. Cox regression analysis was used to evaluate the risk of in-hospital death considering serum uric acid levels and all the comorbidities. In the overall sample, hyperuricemia was independently associated to an increased risk of in-hospital mortality. This effect was stronger in patients with chronic kidney disease while, in the group of patients with normal renal function, the relationship between hyperuricemia and increased stroke mortality was not confirmed. Hyperuricemia could be associated to higher in-hospital mortality for ischemic stroke among elderly patients when affected by kidney disease. Survival does not seem to be affected by hyperuricemia in patients with normal kidney function.

CHA2DS2-VASc scores and Intermountain Mortality Risk Scores for the joint risk stratification of dementia among patients with atrial fibrillation

“…21 Kidney dysfunction is associated with AF, AF-related comorbidities (including stroke), response to targeted therapies for AF, as well as cognitive decline and dementia. [22][23][24][25][26][27] Highlighting the vascular, kidney, and brain connection, the presence of vascular nephropathy was independently associated with a 15-fold increase in white matter changes found by cranial imaging in a study of 52 patients with chronic kidney disease. 26 As more biomarkers of vascular health are surveyed that involve multiple pathways of vessel physiology, the strength of the association with cerebral vascular injury increases.…”

Faktor-Faktor Risiko Stroke Pada Penyakit Ginjal Kronik Stadium v Yang Menjalani Hemodialisis

“…Lorenzo dkk melaporkan bahwa penyakit ginjal kronik dan hiperurisemia berkaitan dengan peningkatan risiko dan prognosis yang buruk pada stroke iskemik akut. 31 Asam urat juga menginduksi stres oksidatif dan disfungsi endotel, sehingga menyebabkan hipertensi sistemik dan hipertensi glomerulus. [30][31] Penurunan laju filtrasi glomerulus (LFG) berkaitan dengan prevalensi yang tinggi untuk terjadinya stroke.…”

“…31 Asam urat juga menginduksi stres oksidatif dan disfungsi endotel, sehingga menyebabkan hipertensi sistemik dan hipertensi glomerulus. [30][31] Penurunan laju filtrasi glomerulus (LFG) berkaitan dengan prevalensi yang tinggi untuk terjadinya stroke. Boss dkk melaporkan bahwa penurunan LFG menyebabkan penyakit pembuluh darah kecil tidak hanya pada ginjal tetapi juga pada otak.…”

Associations between Uric Acid Level and 3-Month Functional Outcome in Acute Ischemic Stroke Patients Treated with/without Edaravone

“…Several studies reported poor outcomes in stroke patients with hyperuricemia [7-9]. They reported a dose-dependent relationship between UA levels and stroke outcome [7, 8].…”

“…They reported a dose-dependent relationship between UA levels and stroke outcome [7, 8]. One reported that UA >7 mg/dL was associated with in-hospital mortality [9], another demonstrated a U-shaped relation [10], and still others reported no particular relationships between UA levels and stroke outcome [11-14]. However, opposite effects have also been reported: hyperuricemia is considered to be a protective factor for stroke [15-20].…”