Impact of Renal Function on Short-Term Outcome After Reperfusion Therapy in Patients With Ischemic Stroke-Reference-Cited by-同舟云学术

Impact of Renal Function on Short-Term Outcome After Reperfusion Therapy in Patients With Ischemic Stroke

Published:2022-12 Issue:12 Volume:53 Page:3622-3632
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Park Hyungjong¹^ORCID,Kim Young Dae²^ORCID,Nam Hyo Suk²^ORCID,Yoo Joonsang³^ORCID,Sohn Sung-Il¹^ORCID,Hong Jeong-Ho¹^ORCID,Kim Byung Moon⁴,Kim Dong Joon⁴^ORCID,Bang Oh Young⁵^ORCID,Seo Woo-Keun⁵^ORCID,Chung Jong-Won⁵^ORCID,Lee Kyung-Yul⁶^ORCID,Jung Yo Han⁶^ORCID,Lee Hye Sun⁷^ORCID,Ahn Seong Hwan⁸^ORCID,Shin Dong Hoon⁹^ORCID,Choi Hye-Yeon¹⁰,Cho Han-Jin¹¹^ORCID,Baek Jang-Hyun¹²^ORCID,Kim Gyu Sik¹³^ORCID,Seo Kwon-Duk¹³^ORCID,Kim Seo Hyun¹⁴^ORCID,Song Tae-Jin¹⁵^ORCID,Kim Jinkwon³^ORCID,Han Sang Won¹⁶^ORCID,Park Joong Hyun¹⁶^ORCID,Lee Suk Ik¹⁷^ORCID,Heo Joon Nyung²^ORCID,Lee Hyung Woo²^ORCID,Lee Il Hyung²^ORCID,Baik Minyoul²^ORCID,Heo Ji Hoe²^ORCID,

Affiliation:

1. Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea (H.P., S.-I.S., J.-H.H.).

2. Department of Neurology (Y.D.K., H.S.N., J.N.H., H.W.L., I.H.L., M.B., J.H.H.), Yonsei University College of Medicine, Seoul, South Korea.

3. Department of Neurology, Yongin Severance Hospital (J.Y., J.K.), Yonsei University College of Medicine, Seoul, South Korea.

4. Department of Radiology (B.M.K., D.J.K.), Yonsei University College of Medicine, Seoul, South Korea.

5. Department of Neurology, Samsung Medical Center (O.Y.B., W.-K.S., J.-W.C.), Sungkyunkwan University School of Medicine, Seoul, South Korea.

6. Department of Neurology, Gangnam Severance Hospital, Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea (K.Y.L., Y.H.J.).

7. Department of Research Affairs, Biostatistics Collaboration Unit (H.S.L.), Yonsei University College of Medicine, Seoul, South Korea.

8. Department of Neurology, Chosun University School of Medicine, Gwangju, South Korea (S.H.A.).

9. Department of Neurology, Gachon University Gil Medical Center, Incheon, South Korea (D.H.S.).

10. Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, South Korea (H.-Y.C.).

11. Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea (H.-J.C.).

12. Department of Neurology, Kangbuk Samsung Hospital (J.-H.B.), Sungkyunkwan University School of Medicine, Seoul, South Korea.

13. Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea (G.S.K., K.-D.S.).

14. Department of Neurology, Yonsei University Wonju College of Medicine, South Korea (S.H.K.).

15. Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea (T.-J.S.).

16. Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea (S.W.H., J.H.P.).

17. Department of Neurology, Sanbon Hospital, Wonkwang University School of Medicine, Sanbon, South Korea (S.I.L.).

Abstract

Background: A high and low estimated glomerular filtration rate (eGFR) could affect outcomes after reperfusion therapy for ischemic stroke. This study aimed to determine whether renal function based on eGFR affects mortality risk in patients with ischemic stroke within 6 months following reperfusion therapy. Methods: This prospective registry–based cohort study included 2266 patients who received reperfusion therapy between January 2000 and September 2019 and were registered in the SECRET (Selection Criteria in Endovascular Thrombectomy and Thrombolytic Therapy) study or the Yonsei Stroke Cohort. A high and low eGFR were based on the Chronic Kidney Disease Epidemiology Collaboration equation and defined, respectively, as the 5th and 95th percentiles of age- and sex-specific eGFR. Occurrence of death within 6 months was compared among the groups according to their eGFR such as low, normal, or high eGFR. Results: Of the 2266 patients, 2051 (90.5%) had a normal eGFR, 110 (4.9%) a low eGFR, and 105 (4.6%) a high eGFR. Patients with high eGFR were younger or less likely to have hypertension, diabetes, or atrial fibrillation than the other groups. Active cancer was more prevalent in the high-eGFR group. During the 6-month follow-up, there were 24 deaths (22.9%) in the high-eGFR group, 37 (33.6%) in the low-eGFR group, and 237 (11.6%) in the normal-eGFR group. After adjusting for variables with P <0.10 in the univariable analysis, 6-month mortality was independently associated with high eGFR (hazard ratio, 2.22 [95% CI, 1.36–3.62]; P =0.001) and low eGFR (HR, 2.29 [95% CI, 1.41–3.72]; P =0.001). These associations persisted regardless of treatment modality or various baseline characteristics. Conclusions: High eGFR as well as low eGFR were independently associated with 6-month mortality after reperfusion therapy. Kidney function could be considered a prognostic factor in patients with ischemic stroke after reperfusion therapy.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference31 articles.

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