Cerebrovascular stroke in chronic kidney disease

Abstract

ObjectiveThe aim of the present study was to investigate the traditional and nontraditional risk factors in chronic kidney disease (CKD) patients with stroke and the role of renal function in the short-term outcome of stroke.BackgroundOver the past decade, considerable evidence has accumulated on the increased incidence of stroke and mortality associated with CKD.Patients and methodsA total of 67 patients with first ever stroke, either ischemic or hemorrhagic, with CKD were compared with 30 first ever stroke patients who were free from the signs and symptoms of CKD.All patients were assessed on admission (day 0) and then followed up at day 7 and day 30. Motor and functional disability was assessed using the National Institutes of Health Stroke Scale, and stroke outcome was assessed using the Barthel index scale.ResultsCKD patients had a significantly higher rate of hemorrhagic stroke than the control group (37.3 vs. 16.6%; P < 0.05). In the hemodialysis population in group II CKD ischemic stroke showed a predominance of vertebrobasilar arterial territory infarcts (P < 0.05). Patients with estimated glomerular filtration rate less than 15 ml/min/1.73 m 2 had the highest motor and functional disability, with a mean National Institutes of Health Stroke Scale score of 16.3 ± 5.9. Patients with CKD had a significantly higher risk of case fatality rate, reaching 41.7%, compared with the control group (30%).ConclusionCKD patients with stroke had a significantly higher risk of case fatality rate; reduced estimated glomerular filtration rate on admission is related to poor stroke outcome. In CKD patients, as serum albumin and hemoglobin level decrease, the severity of stroke increases.