Stroke and renal dysfunction

Fabjan, Tanja Hojs; Hojs, Radovan

doi:10.1016/j.ejim.2013.08.710

Cited by 27 publications

(17 citation statements)

References 71 publications

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“…Accelerated atherosclerosis is the key factor for the high prevalence of CV diseases in patients with renal dysfunction. 28 Several studies indicated that high PTH levels could be causally involved in the process leading to the manifestation of CV diseases in patients both normal or impaired renal function. 12 , 29 , 30 In an animal study, PTH2 receptor messenger RNA was abundantly expressed in the arterial and cardiac endothelium, which supported the close relationships between PTH and CV risk.…”

Section: Discussionmentioning

confidence: 99%

Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease

et al. 2015

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Research information on the risk of stroke in patients with dialysis-dependent end-stage renal disease (ESRD) who have undergone parathyroidectomy (PTX) is scant.We used a nationwide health insurance claims database to select all patients with dialysis-dependent ESRD age 18 years and older for the study population. Of the patients with ESRD, we selected 1083 patients who had undergone PTX between 1998 and 2006 as the PTX group and frequency-matched 1083 patients with ESRD by sex, age, years since the disease diagnosis, and the year of undergoing PTX as the non-PTX group.We used a multivariate Cox proportional hazards regression analysis to measure the risk of stroke for the PTX group compared with the non-PTX group after adjusting for sex, age, premium-based income, urbanization, and comorbidity.The mean follow-up periods were 6.08 and 5.38 years for the PTX and non-PTX groups, respectively. After adjusting for previously mentioned variables, significant risk reductions of stroke (adjusted hazard ratio = 0.57, 95% confidence interval = 0.41–0.79), particularly those of hemorrhagic stroke (adjusted hazard ratio = 0.34, 95% confidence interval = 0.20–0.57), with PTX were observed. Chronologically, the risk of stroke in the PTX group decreased in the second year after PTX and persisted for >3 years.PTX reduces the risk of stroke, particularly that of hemorrhagic stroke, in patients with dialysis-dependent ESRD. Other factors for risk reduction include sex (females), an age <65 years, and the presence of comorbidity.

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Section: Discussionmentioning

confidence: 99%

Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease

et al. 2015

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“…If we used a more quantitative definition to capture patients with higher levels of proteinuria, an association with mortality could have been detected as shown in some studies that reported proteinuria as independently associated with poor stroke outcomes. 12,16 Our study has limitations. Not all our cohort underwent Cr measurement at baseline.…”

Section: Discussionmentioning

confidence: 92%

“…11 Another study reported that following a stroke, both short term (30 days) and long-term mortality rates are significantly higher in those with renal dysfunction. 12 The impact of CKD on stroke mortality may have several mechanisms. Both the brain and the kidneys are low-resistance-end arterial organs that allow for high-volume perfusion con-tinuously and passively throughout systole and diastole.…”

Section: Discussionmentioning

confidence: 99%

Abnormal admission kidney function predicts higher mortality in stroke patients

Mekhlafi

Ibrahim

Rayyis

2018

NSJ

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“…Renal involvement is a typical disease characteristic of FD patients. The link between chronic kidney disease and cerebrovascular disease has become more apparent [ 41 ]. Our results also showed that the creatinine level was significantly higher in the events group than in the no-events group and creatinine ≥ 1.0 mg/dl serves as an independent predictor of new-onset or recurrent stroke/TIA in FD patients without AF.…”

Section: Discussionmentioning

confidence: 99%

Value of the CHA2DS2-VASc score and Fabry-specific score for predicting new-onset or recurrent stroke/TIA in Fabry disease patients without atrial fibrillation

Liú

Schmidt

et al. 2018

Clin Res Cardiol

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ObjectivesTo evaluate potential risk factors for stroke or transient ischemic attacks (TIA) and to test the feasibility and efficacy of a Fabry-specific stroke risk score in Fabry disease (FD) patients without atrial fibrillation (AF).BackgroundFD patients often experience cerebrovascular events (stroke/TIA) at young age.Methods159 genetically confirmed FD patients without AF (aged 40 ± 14 years, 42.1% male) were included, and risk factors for stroke/TIA events were determined. All patients were followed up over a median period of 60 (quartiles 35–90) months. The pre-defined primary outcomes included new-onset or recurrent stroke/TIA and all-cause death.ResultsPrior stroke/TIA (HR 19.97, P < .001), angiokeratoma (HR 4.06, P = .010), elevated creatinine (HR 3.74, P = .011), significant left ventricular hypertrophy (HR 4.07, P = .017), and reduced global systolic strain (GLS, HR 5.19, P = .002) remained as independent risk predictors of new-onset or recurrent stroke/TIA in FD patients without AF. A Fabry-specific score was established based on above defined risk factors, proving somehow superior to the CHA2DS2-VASc score in predicting new-onset or recurrent stroke/TIA in this cohort (AUC 0.87 vs. 0.75, P = .199).ConclusionsPrior stroke/TIA, angiokeratoma, renal dysfunction, left ventricular hypertrophy, and global systolic dysfunction are independent risk factors for new-onset or recurrent stroke/TIA in FD patients without AF. It is feasible to predict new or recurrent cerebral events with the Fabry-specific score based on the above defined risk factors. Future studies are warranted to test if FD patients with high risk for new-onset or recurrent stroke/TIA, as defined by the Fabry-specific score (≥ 2 points), might benefit from antithrombotic therapy. Clinical trial registration HEAL-FABRY (evaluation of HEArt invoLvement in patients with FABRY disease, NCT03362164).Electronic supplementary materialThe online version of this article (10.1007/s00392-018-1285-4) contains supplementary material, which is available to authorized users.

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Stroke and renal dysfunction

Cited by 27 publications

References 71 publications

Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease

Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease

Abnormal admission kidney function predicts higher mortality in stroke patients

Value of the CHA2DS2-VASc score and Fabry-specific score for predicting new-onset or recurrent stroke/TIA in Fabry disease patients without atrial fibrillation

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