Prognostic Relationships between Microbleed, Lacunar Infarction, White Matter Lesion, and Renal Dysfunction in Acute Ischemic Stroke Survivors
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- 作者：Jae Woong Jeon ; MD* ; Hye Seon Jeong ; MD&dagger ; ; hyuuu28@cnuh.co.kr ; Dae Eun Choi ; MD ; PhD* ; daenii@cnu.ac.kr ; Young Rok Ham ; MD* ; Ki Ryang Na ; MD ; PhD* ; Kang Wook Lee ; MD ; PhD* ; Jong Wook Shin ; MD&dagger ; ; Jei Kim ; MD&dagger ;
- 关键词：Chronic renal disease ; stroke ; cerebral small-vessel disease ; mortality
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：26
- 期：2
- 页码：385-392
- 全文大小：321 K
- 卷排序：26
文摘
It is well known that renal dysfunction and cerebral small-vessel disease (SVD), including microbleed, lacunar infarction, and white matter lesion (WML), are associated with poor prognosis after ischemic stroke. However, the prognostic relationship between renal dysfunction and SVD has not been well evaluated in acute ischemic stroke survivors. Therefore, in this study, we evaluated the prognostic relationships between estimated glomerular filtration rate (eGFR) and cerebral SVD after acute ischemic stroke.MethodsWe retrospectively reviewed the clinical and radiological data of acute ischemic stroke survivors with decreased eGFR (<60 mL/min/1.73 m2, n = 128) and controls (eGFR ≥60 mL/min/1.73 m2, n = 128). The presence of SVD was evaluated according to magnetic resonance imaging performed on admission. Mortality data were obtained from medical chart reviews and telephone interviews.ResultsPatients with silent lacunar infarction, WML, or microbleed had lower eGFR than patients without such lesions (60.4 ± 34.8 versus 87.5 ± 28.4 mL/min/1.73 m2, 60.5 ± 37.1 versus 73.9 ± 33.3 mL/min/1.73 m2, and 57.6 ± 33.3 versus 73.9 ± 32.9 mL/min/1.73 m2, respectively). In addition, the multivariate adjusted odds ratio for the presence of SVD increased inversely with eGFR. Three-year survival was lower in patients with renal dysfunction and each type of SVD. The presence of WML was an independent risk factor for cardiovascular death.ConclusionsRenal impairment was associated with the presence of SVD in acute ischemic stroke survivors. Both renal impairment and the presence of SVD were predictors of poor poststroke survival.