Renal function is associated with 1-month and 1-year mortality in patients with ischemic stroke

I. Kuan Wang, Chung Hsiang Liu, Tzung Hai Yen, Jiann Shing Jeng, Sheng Feng Sung, Pai Hao Huang, Jie Yuan Li, Yu Sun, Cheng Yu Wei, Li Ming Lien, I. Ju Tsai, Fung Chang Sung, Chung Y. Hsu, Chung Hsiang Liu, Chon Haw Tsai, Wei Shih Huang, Chung Ta Lu, Tzung Chang Tsai, Chun Hung Tseng, Kang Hsu LinWoei Cherng Shyu, Yu Wan Yang, Yen Liang Liu, Der Yang Cho, Chun Chung Chen, Sung Chun Tang, Li Kai Tsai, Shin Joe Yeh, Chih Hao Chen, Hsin Hsi Tsai, Han Jung Chen, Kan Lu, Shih Pin Hsu, Hung Chang Kuo, Jung Chi Tsou, Yan Tang Wang, Yi Cheng Tai, Meng Tsang Hsieh, Po Chao Liliang, Cheng Loong Liang, Hao Kuang Wang, Yu Tun Tsai, Kuo Wei Wang, Jui Sheng Chen, Po Yuan Chen, Yi Ching Wang, Pi Shan Sung, Han Chieh Hsieh, Hui Chen Su, Hou Chang Chiu, Jia-Ying Sung, Chin-I Chen, Lung Chan, Shu-Ping Chao, Chih-Shan Huang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and aims: Renal dysfunction is a potent risk factor for cardiovascular diseases, including stroke. This study aimed to evaluate the impact of admission estimated glomerular filtration rate (eGFR) levels on short-term (1-month) and long-term (1-year) mortality in patients with acute ischemic stroke. Methods: From the Taiwan Stroke Registry data, we classified ischemic stroke patients, identified from April 2006 to December 2015, into 5 groups by eGFR at admission: ≥ 90, 60–89, 30–59, 15–29, and <15 mL/min/1.73 m2 or on dialysis. Risks of 1-month mortality and 1-year mortality after ischemic stroke were investigated by the eGFR level. Results: Among 52,732 ischemic stroke patients, 1480 died within one month. The 1-month mortality rate was over 5-fold greater in patients with eGFR <15 mL/min/1.73 m2 or dialysis than in patients with eGFR ≥90 mL/min/1.73 m2 (2.88 versus 0.56 per 1000 person-days). The adjusted hazard ratio (HR) of 1-month mortality increased from 1.31 (95% CI = 1.08–1.59) for patients with eGFR 60–89 mL/min/1.73 m2 to 2.33 (95% CI = 1.80–3.02) for patients with eGFR < 15 mL/min/1.73 m2 or on dialysis. 3226 patients died within one year. The adjusted HR of mortality increased from 1.38 (95% CI = 1.21–1.59) for patients with eGFR 60–89 mL/min/1.73 m2 to 2.60 (95% CI 2.18–3.10) for patients with eGFR < 15 mL/min/1.73 m2 or on dialysis, compared to patients with eGFR ≥ 90 mL/min/1.73 m2. Conclusions: After acute ischemic stroke, patients with reduced eGFR are at elevated risks of short-term and long-term deaths in a graded relationship.

Original languageEnglish
Pages (from-to)288-293
Number of pages6
JournalAtherosclerosis
Volume269
DOIs
Publication statusPublished - Feb 1 2018

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Keywords

  • Estimated glomerular filtration rate
  • Ischemic stroke
  • Mortality
  • Renal function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Wang, I. K., Liu, C. H., Yen, T. H., Jeng, J. S., Sung, S. F., Huang, P. H., Li, J. Y., Sun, Y., Wei, C. Y., Lien, L. M., Tsai, I. J., Sung, F. C., Hsu, C. Y., Liu, C. H., Tsai, C. H., Huang, W. S., Lu, C. T., Tsai, T. C., Tseng, C. H., ... Huang, C-S. (2018). Renal function is associated with 1-month and 1-year mortality in patients with ischemic stroke. Atherosclerosis, 269, 288-293. https://doi.org/10.1016/j.atherosclerosis.2017.11.029