Even mild kidney dysfunction raises recurrent stroke risk

Diminished renal function is an independent risk factor for recurrent stroke within the first 6 months following hospitalization for an acute ischemic stroke, Dr. Abraham Thomas reported at the International Stroke Conference.

The short-term risk of recurrent stroke climbs in stepwise fashion with decreasing renal function. Even patients categorized as having stage 2 renal function by National Kidney Foundation criteria – those with an estimated glomerular filtration rate of 60-89 mL/min/1.73 m² – have a 60% increased risk compared with those who have an estimated GFR of 90 or greater, according to Dr. Thomas of the University of California, San Francisco.

He presented an observational study involving 2,882 patients admitted with acute ischemic stroke to 12 Northern California Kaiser Permanente hospitals during 2004-2007. Twenty-four percent had stage 1 renal function upon admission, with an eGFR of at least 90 mL/min/1.73 m². Forty-seven percent were stage 2, 25% were stage 3 as defined by an eGFR of 30-59, and the rest had stage 4 chronic kidney disease.

In a multivariate analysis, stage 2 renal function was independently associated with a 60% greater risk of recurrent stroke within 6 months compared with those who were stage 1. Patients with stage 3 renal function were at 70% greater risk than were those who were stage 1, while stage 4 patients were at 80% increased risk.

Renal dysfunction is an established risk factor for first-time cardiovascular events, including stroke. But the relationship between renal function and short-term risk of recurrent stroke has not previously been scrutinized.

One possible mechanism by which impaired renal function might predict an increased short-term risk of recurrent stroke involves poor blood pressure control, Dr. Thomas observed. The prevalence of hypertension was 19% with stage 1 renal function, 24% in those who were stage 2, and 26% in patients with stage 3 or 4 renal function. And at 6 months’ follow-up, blood pressure control was less than half as common among stage 4 patients than in those who were stages 1-3.

The conference was sponsored by the American Heart Association. Dr. Thomas reported having no financial conflicts.

[email protected]

Diminished renal function is an independent risk factor for recurrent stroke within the first 6 months following hospitalization for an acute ischemic stroke, Dr. Abraham Thomas reported at the International Stroke Conference.

The short-term risk of recurrent stroke climbs in stepwise fashion with decreasing renal function. Even patients categorized as having stage 2 renal function by National Kidney Foundation criteria – those with an estimated glomerular filtration rate of 60-89 mL/min/1.73 m² – have a 60% increased risk compared with those who have an estimated GFR of 90 or greater, according to Dr. Thomas of the University of California, San Francisco.

He presented an observational study involving 2,882 patients admitted with acute ischemic stroke to 12 Northern California Kaiser Permanente hospitals during 2004-2007. Twenty-four percent had stage 1 renal function upon admission, with an eGFR of at least 90 mL/min/1.73 m². Forty-seven percent were stage 2, 25% were stage 3 as defined by an eGFR of 30-59, and the rest had stage 4 chronic kidney disease.

In a multivariate analysis, stage 2 renal function was independently associated with a 60% greater risk of recurrent stroke within 6 months compared with those who were stage 1. Patients with stage 3 renal function were at 70% greater risk than were those who were stage 1, while stage 4 patients were at 80% increased risk.

Renal dysfunction is an established risk factor for first-time cardiovascular events, including stroke. But the relationship between renal function and short-term risk of recurrent stroke has not previously been scrutinized.

One possible mechanism by which impaired renal function might predict an increased short-term risk of recurrent stroke involves poor blood pressure control, Dr. Thomas observed. The prevalence of hypertension was 19% with stage 1 renal function, 24% in those who were stage 2, and 26% in patients with stage 3 or 4 renal function. And at 6 months’ follow-up, blood pressure control was less than half as common among stage 4 patients than in those who were stages 1-3.

The conference was sponsored by the American Heart Association. Dr. Thomas reported having no financial conflicts.

[email protected]

Diminished renal function is an independent risk factor for recurrent stroke within the first 6 months following hospitalization for an acute ischemic stroke, Dr. Abraham Thomas reported at the International Stroke Conference.

The short-term risk of recurrent stroke climbs in stepwise fashion with decreasing renal function. Even patients categorized as having stage 2 renal function by National Kidney Foundation criteria – those with an estimated glomerular filtration rate of 60-89 mL/min/1.73 m² – have a 60% increased risk compared with those who have an estimated GFR of 90 or greater, according to Dr. Thomas of the University of California, San Francisco.

He presented an observational study involving 2,882 patients admitted with acute ischemic stroke to 12 Northern California Kaiser Permanente hospitals during 2004-2007. Twenty-four percent had stage 1 renal function upon admission, with an eGFR of at least 90 mL/min/1.73 m². Forty-seven percent were stage 2, 25% were stage 3 as defined by an eGFR of 30-59, and the rest had stage 4 chronic kidney disease.

In a multivariate analysis, stage 2 renal function was independently associated with a 60% greater risk of recurrent stroke within 6 months compared with those who were stage 1. Patients with stage 3 renal function were at 70% greater risk than were those who were stage 1, while stage 4 patients were at 80% increased risk.

Renal dysfunction is an established risk factor for first-time cardiovascular events, including stroke. But the relationship between renal function and short-term risk of recurrent stroke has not previously been scrutinized.

One possible mechanism by which impaired renal function might predict an increased short-term risk of recurrent stroke involves poor blood pressure control, Dr. Thomas observed. The prevalence of hypertension was 19% with stage 1 renal function, 24% in those who were stage 2, and 26% in patients with stage 3 or 4 renal function. And at 6 months’ follow-up, blood pressure control was less than half as common among stage 4 patients than in those who were stages 1-3.

The conference was sponsored by the American Heart Association. Dr. Thomas reported having no financial conflicts.

[email protected]