Abstract WP388: The Impact of Chronic Kidney Disease on the Outcome of Large Artery Atherosclerotic Stroke: Results from Taiwan Stroke Registry
Background and Purpose: Chronic kidney disease (CKD) has been shown a risk factor for the development of large artery atherosclerosis (LAA) and stroke. However, its impact on the outcome of acute stroke patients with LAA has not been well investigated.
Methods: Patients who were prospectively registered in Taiwan Stroke Registry (TSR) and had LAA subtype of acute ischemic stroke were included. The severity of CKD was evaluated by estimated glomerular filtration rate (eGFR) as normal (>90 mL/min/1.73 m2), mild (60-89 mL/min/1.73 m2), moderate (30-59 mL/min/1.73 m2), and severe (<30 mL/min/1.73 m2) renal function impairment. The association of renal function with acute stroke severity was analyzed. Logistic regression analysis, Kaplan-Meier method and Cox proportional hazard model were applied to assess factors determining the outcome, recurrent stroke and death at 6 months after stroke.
Results: Between May, 2006 and April, 2009, there were 7728 patients (male, 61.8%; average age, 68.6 years) with LAA subtype of ischemic stroke. Acute stroke severity (represented as initial NIHSS scores) was correlated significantly with moderate and severe CKD (P=0.026 and <0.0001, respectively). The severity of CKD was not significantly related to functional outcome at 6 months after stroke. However, patients with moderate (adjusted hazard ratio, 2.62; 95% confidence interval, 1.18-5.83) and severe (adjusted hazard ratio, 5.48; 95% confidence interval, 2.39-12.56) CKD had higher mortality at 6 months after stroke.
Conclusions: In patients with LAA of acute ischemic stroke, the severity of CKD at admission is crucial for prediction of 6 months post stroke mortality.
- © 2012 by American Heart Association, Inc.