Chronic Kidney Disease and Outcome Following Endovascular Thrombectomy for Acute Ischemic Stroke

2020 ◽  
Vol 29 (4) ◽  
pp. 104665 ◽  
Author(s):  
Luke J. Sutherland ◽  
William K. Diprose ◽  
Michael T.M. Wang ◽  
P. Alan Barber
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Acute Ischemic Stroke ◽  
Endovascular Thrombectomy

Abstract TP199: Cerebral Microblees and Chronic Kidney Disease in Patients With First-ever Acute Ischemic Stroke or Transient Ischemic Attack

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Asako Nakamura ◽  
Masahiro Yasaka ◽  
Takahiro Kuwashiro ◽  
Seiji Gotoh ◽  
Yasuyuki Nakanishi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Acute Ischemic Stroke ◽  
Transient Ischemic Attack ◽  
Ischemic Attack

scholarly journals Association between chronic kidney disease and outcomes among admissions for acute ischemic stroke receiving thrombolysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Weeda
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Acute Ischemic Stroke ◽  
Funding Source ◽  
National Inpatient Sample ◽  
Risk Of Bleeding ◽  
Diagnostic Coding

Abstract Background Patients with chronic kidney disease may have hemostatic defects that increase the risk of bleeding following the administration of thrombolysis. Purpose We assessed the association between chronic kidney disease and intracerebral hemorrhage in acute ischemic stroke admissions receiving thrombolysis. Methods Using administrative data from the 2013 and 2014 National Inpatient Sample, adult acute ischemic stroke admissions treated with thrombolysis were identified. Patients with chronic kidney disease were identified via diagnostic coding. We used multivariable logistic regression to estimate the odds of intracerebral hemorrhage in patients with chronic kidney disease after adjustment for age and comorbidities. The association between chronic kidney disease and in-hospital mortality was also evaluated. Results Of 13,993 admissions treated with thrombolysis for acute ischemic stroke, 12.4% (n=1,739) had chronic kidney disease. Intracerebral hemorrhage occurred in 7.6% of patients and 7.0% experienced in hospital mortality. Chronic kidney disease did not increase the odds of intracerebral hemorrhage (odds ratio [OR]=1.00; 95% confidence interval [CI]=0.83–1.20). The adjusted odds of in-hospital mortality were also no different in those with versus without chronic kidney disease (OR=1.19; 95% CI=0.99–1.42). Conclusions Among admissions treated with thrombolysis for acute ischemic stroke, chronic kidney disease was not associated with a higher adjusted odd of intracerebral hemorrhage. Chronic kidney disease did not increase the odds of in-hospital mortality. Funding Acknowledgement Type of funding source: Other. Main funding source(s): SmartState Medication Safety

scholarly journals Association of lipid profiles with severity and outcome of acute ischemic stroke in patients with and without chronic kidney disease

2020 ◽  
Author(s):  
Ailing Zhang ◽  
Wenjing Deng ◽  
Bin Zhang ◽  
Mengyang Ren ◽  
Long Tian ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Acute Ischemic Stroke ◽  
Lipid Profiles ◽  
Stepwise Logistic Regression ◽  
Stroke Severity ◽  
Severe Stroke ◽  
Adjusted Risk ◽  
Lipid Components

Abstract Background Contribution of lipid profiles to stroke severity and outcome was inconclusive, whether chronic kidney disease (CKD) (estimated glomerular filtration rate < 60 mL/min/1.73 m2) affects the association has not been investigated. We aim to evaluate this relationship. Methods A retrospective study of consecutive acute ischemic stroke patients was performed. We assessed the risk of severe stroke with the National Institutes of Health Stroke Scale (NIHSS) ≥ 5 at admission and poor outcome with the modified Rankin Scale (mRS) ≥ 3 at discharge. Multivariate stepwise logistic regression models were adopted to study interaction and independent association of lipid components with stroke severity and outcome according to lipid level quartiles by CKD stratification. Results Among the 875 included patients (mean age 64.9 years, 67.8% males), 213 (24.3%) presented with CKD. Elevated low-density lipoprotein cholesterol (LDL-C) was independently associated with severe stroke in patients with CKD (P for trend = 0.033) than in those without CKD (P for trend = 0.121). The association between the level of LDL-C and stroke severity was appreciably modified by CKD (Pinteraction = 0.013). Compared with without CKD patients in the lowest LDL-C quartile, the multivariable-adjusted risk of severe stroke increased significantly by 2.9-fold (95% CI 1.48–5.74) in patients with CKD in the highest LDL-C quartile. No significant association was observed between lipid components and early outcome in patients with and without CKD. Conclusion LDL-C levels are positively associated with stroke severity in only patients with CKD, with an interactive impact of LDL-C and CKD on ischemic stroke in the acute phase.

scholarly journals Impaired kidney function evaluated with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is associated with more severe acute ischemic stroke

2017 ◽  
Vol 22 (5) ◽  
pp. 432-434 ◽  
Author(s):  
Konstantinos Tziomalos ◽  
Marina Georgaraki ◽  
Stella D Bouziana ◽  
Marianna Spanou ◽  
Stavroula Kostaki ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Acute Ischemic Stroke ◽  
Kidney Function ◽  
Disease Epidemiology

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

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Lorenzo Falsetti ◽  
William Capeci ◽  
Nicola Tarquinio ◽  
Giovanna Viticchi ◽  
Mauro Silvestrini ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Acute Ischemic Stroke ◽  
Serum Uric Acid ◽  
Kidney Function ◽  
Increased Risk

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.

scholarly journals Acute Ischemic Stroke and Acute on Chronic Kidney Disease

2016 ◽  
Vol 54 (202) ◽  
pp. 85-87
Author(s):  
Raja Ahsan Aftab ◽  
Amer Hayat Khan ◽  
Hadeer Akram AbdulRazzaq ◽  
Azreen Syazril Adnan
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Kidney Disease ◽  
Acute Ischemic Stroke ◽  
Thrombus Formation ◽  
Chronic Kidney Disease Stage ◽  
Sudden Onset ◽  
Disease Stage ◽  
Uncontrolled Hypertension ◽  
Ischemic Disease

Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity. Here wer present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden onset of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus(un controlled). He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis), acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and carefull selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition. Keywords: ischemic disease; chronic kidney disease; uncontrolled hypertension. | PubMed

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