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. 2016 Aug 30;11(8):e0159775.
doi: 10.1371/journal.pone.0159775. eCollection 2016.

Renal Dysfunction in Post-Stroke Patients

Kamil Chwojnicki  1 , Ewa Król  2 , Łukasz Wierucki  3 , Grzegorz Kozera  1 , Piotr Sobolewski  4 , Walenty M Nyka  1 , Tomasz Zdrojewski  3
Affiliations

Renal Dysfunction in Post-Stroke Patients

Kamil Chwojnicki et al. PLoS One. .

Abstract

Background: The presence of chronic kidney disease (CKD) is an indicator of a worse long-term prognosis in patients with ischemic stroke (IS). Unfortunately, not much is known about renal function in the population of post-IS subjects. The aim of our study was to assess the prevalence of renal damage and impaired renal function (IRF) in the population of post-IS subjects.

Methods: This prospective analysis concerned 352 consecutive post-IS survivors hospitalized in Pomeranian stroke centers (Poland) in 2009. In this group estimated glomerular filtration rate (eGFR) according to MDRD (modification of diet in renal diseases) and CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formulas and urine albumin/creatinine ratio (ACR) were determined.

Results: Among survivors decreased eGFR (<60 mL/min./1.73m2 according to MDRD or CKD-EPI) or ACR≥30mg/g were detected in 40.38% (23.07% Men, 55.32% Women; P<0.01). The highest prevalence of IRF was noted in post-IS subjects with atheromatic and lacunar IS. In multivariate analysis the ACR≥30mg/g was predicted by older age, diabetes mellitus (DM) and physical disability (modified Rankin scale 3-5 pts.). The association with reduced eGFR was proved for sex (female), DM and physical disability.

Conclusions: CKD is a frequently occurring problem in the group of post-IS subjects, especially after lacunar and atheromatic IS. Post-IS patients, mainly the elderly women, with physical disability and diabetes mellitus, should be regularly screened for CKD. This could reduce the risk of further cardiovascular events and delay the progression of IRF.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Distribution of stage 3 to 5 of chronic kidney disease on the basis of glomerular filtration rate measured according to MDRD and CKD-EPI formulas in post-IS subjects.
Fig 2
Fig 2. Frequency of diminished kidney function (eGFR < 60 mL/min/1.73m2) estimated by MDRD and CKD-EPI formulas and albuminuria measured as urine albumin to creatinine ratio (ACR) in survivors with ischemic stroke according to IS etiology.
See this image and copyright information in PMC

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MeSH terms