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

被引：12

作者：

Park, Hyungjong ^{[1
]}

Kim, Young Dae ^{[2
]}

Nam, Hyo Suk ^{[2
]}

Yoo, Joonsang ^{[3
]}

Sohn, Sung-Il ^{[1
]}

Hong, Jeong-Ho ^{[1
]}

Kim, Byung Moon ^{[4
]}

Kim, Dong Joon ^{[4
]}

Bang, Oh Young ^{[6
]}

Seo, Woo-Keun ^{[6
]}

Chung, Jong-Won ^{[6
]}

Lee, Kyung-Yul ^{[8
]}

Jung, Yo Han ^{[8
]}

Lee, Hye Sun ^{[5
]}

Ahn, Seong Hwan ^{[9
]}

Shin, Dong Hoon ^{[10
]}

Choi, Hye-Yeon ^{[11
]}

Cho, Han-Jin ^{[12
]}

Baek, Jang-Hyun ^{[7
]}

Kim, Gyu Sik ^{[13
]}

Seo, Kwon-Duk ^{[13
]}

Kim, Seo Hyun ^{[14
]}

Song, Tae-Jin ^{[15
]}

Kim, Jinkwon ^{[3
]}

Han, Sang Won ^{[16
]}

Park, Joong Hyun ^{[16
]}

Lee, Suk Ik ^{[17
]}

Heo, Joon Nyung ^{[2
]}

Lee, Hyung Woo ^{[2
]}

Lee, Il Hyung ^{[2
]}

Baik, Minyoul ^{[2
]}

Heo, Ji Hoe ^{[2
]}

机构：

[1] Keimyung Univ, Dept Neurol, Sch Med, Daegu, South Korea

[2] Yonsei Univ, Coll Med, Dept Neurol, 50-1 Yonsei Ro, Seoul 03722, South Korea

[3] Yonsei Univ, Coll Med, Dept Neurol, Yongin Severance Hosp, Seoul, South Korea

[4] Yonsei Univ, Coll Med, Dept Radiol, Seoul, South Korea

[5] Yonsei Univ, Coll Med, Dept Res Affairs, Biostat Collaborat Unit, Seoul, South Korea

[6] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Neurol, Seoul, South Korea

[7] Sungkyunkwan Univ, Sch Med, Dept Neurol, Kangbuk Samsung Hosp, Seoul, South Korea

[8] Yonsei Univ, Severance Inst Vasc & Metab Res, Gangnam Severance Hosp, Dept Neurol,Coll Med, Seoul, South Korea

[9] Chosun Univ, Dept Neurol, Sch Med, Gwangju, South Korea

[10] Gachon Univ, Dept Neurol, Gil Med Ctr, Incheon, South Korea

[11] Kyung Hee Univ, Kyung Lee Univ Hosp Gangdong, Sch Med, Dept Neurol, Seoul, South Korea

[12] Pusan Natl Univ, Pusan Natl Univ Hosp, Sch Med, Dept Neurol, Busan, South Korea

[13] Natl Hlth Insurance Serv Ilsan Hosp, Dept Neurol, Goyang, South Korea

[14] Yonsei Univ, Dept Neurol, Wonju Coll Med, Wonju, South Korea

[15] Ewha Womans Univ, Seoul Hosp, Coll Med, Dept Neurol, Seoul, South Korea

[16] Inje Univ, Sanggye Paik Hosp, Dept Neurol, Coll Med, Seoul, South Korea

[17] Wonkwang Univ, Sanbon Hosp, Dept Neurol, Sch Med, Sanbon, South Korea

来源：

STROKE | 2022年 / 53卷 / 12期

关键词：

glomerular filtration rate; ischemic stroke; mortality; reperfusion; thrombectomy; CHRONIC KIDNEY-DISEASE; GLOMERULAR HYPERFILTRATION; PROGNOSTIC IMPLICATIONS; THROMBOLYSIS; IMPAIRMENT; GUIDELINES; EQUATION;

D O I：

10.1161/STROKEAHA.122.039129

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页码：3622 / 3632

页数：11

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