Evaluation of the prevalence of chronic kidney disease and the risk factors in patients with acute stroke / 国际脑血管病杂志

ABSTRACT

Objective To investigate the prevalence of chronic kidney disease (CKD) in patients with acute stroke and the risk factors and prognostic characteristics in these patients.Methods A total of 270 consecutive hospitalized patients with acute stroke was recruited, and their CKD was evaluated transversally. Various risk factors and short-term prognosis of 53 patients with CKD whose National Institutes of Health Stroke Scale (NIHSS) scores were similar at admission among the 270 patients with stroke were compared to those of 106 patients without CKD. CKD was defined as glomerular filtration rate (GFR) ＜ 60 ml/(min·1.73 m2) and (or) random urinary albumin-to-creatinine ratios (ACR) ＞ 30 mg/g, and continued for more than 3 months. GFR was estimated according to the simplified Modification of Diet in Renal Disease (MDRD) equation, The modified Rankin Scale (mRS) was used to evaluate the shortterm prognosis. Results The prevalence of CKD in these patients was 19.6%, and most of them were early-and middle-stage CKD. The proportions of the histories of hypertension (81.13%), diabetes mellitus (33.96%), and stroke (45.28%) in patients with CKD were significantly higher than those in patients without CKD (64.15%, 18.86% and 27.36%,respectively, all P＜0.05). The mean levels of systolic pressure (151.74±20.98 mm Hg) and low density lipoprotein (3.03±0.96 mmol/L) in patients with CKD were significantly higher than those in patients without CKD (systolic pressure was 144.44±21.13 mm Hg, and low density lipoprotein was 2.75±0.76 mmol/L, all P＜0.05). In addition, the levels of erythrocytes sedimentation rate(median, 39 mm/h), high sensitive C-reactive protein (median,5.12 mg/L) and parathyroid hormone (81.01±26.78 pg/ml) were significantly higher than those in patients without CKD (they were 20 mm/h, 3.36 mg/L, and 46.95±24.63 pg/ml,respectively, all P＜0.05). There was a changing trend in low serum calcium and high serum phosphorus in patients with CKD. The proportion of the patients whose mRS score ≥ 3 at 3 months after the onset in patients with CKD was significantly higher than that in patients without CKD (66.03% vs 46.23%, P＜0.05). The mortality at 3 months (9.43%) also had an increasing tendency (P=0.073). Conclusions The prevalence of CKD was higher among the stroke population, and most of them were early-and middle-stage CKD. The stroke patients with CKD had more risk factors and worse prognosis than those without.