Abstract WP447: Renal Failure Is Associated With Cognitive Impairment In Ischemic Stroke Patients
Background and purpose: Mounting evidence suggests that the presence of chronic kidney disease (CKD) predicts poor clinical outcomes in ischemic stroke patients. However few reports are available about the association of CKD and cognitive impairments (CI) after stroke. The aim of this study was evaluate the presence of CKD in patients with CI after stroke.
Methods: all patients included in PROTEGE ACV, a stroke secondary prevention stroke program, were evaluated. Demographic data, vascular risk factors profile and control, CI (abnormal clock drawing test (CDT) or MMSE, adjusted by age and educational level) and CKD (estimated glomerular filtration rate -e-GFR- < 60 ml/min/1.73 m2 or 24 hours microalbuminuria).
Results: 668 (54% female) ischemic stroke patients were included; mean age 75 ± 10 years.. The main vascular risk factors were hypertension (81%), dyslipemia (70%), metabolic syndrome (48%), obesity (42%) and smoking (41%). Pre-stroke hypertension control was good and 74% were under pharmacological treatment.
Post-stroke CI were associated with hypertension (OR 1.65, 95% CI 1-2.59), impaired eGFR (OR 2.51, 95% CI 1,6-3,8), female sex (OR 2.23 95% CI 1.5-3.2) and cardioembolic stroke (OR 2.32, 95% CI 1.5-3.4) in the univariate analysis. In the logistic regression model adjusted by age, sex and main vascular risk factors, age older than 80 years, female sex, cardioembolic stroke and impaired e-GFR were predictors of CI (figure). No relationship was found between CI and microalbuminuria ≥ 20 mg/24hs.
Conclusions: cognitive function is negatively affected by impaired e-GFR. Optimal pre-stroke hypertension control could be an explanation for the small number of patients with high microalbuminuria in our cohort.
- © 2012 by American Heart Association, Inc.