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Impact of Renal Function on Short-Term Outcome After Reperfusion Therapy in Patients With Ischemic Stroke

Authors
 Hyungjong Park  ;  Young Dae Kim  ;  Hyo Suk Nam  ;  Joonsang Yoo  ;  Sung-Il Sohn  ;  Jeong-Ho Hong  ;  Byung Moon Kim  ;  Dong Joon Kim  ;  Oh Young Bang  ;  Woo-Keun Seo  ;  Jong-Won Chung  ;  Kyung-Yul Lee  ;  Yo Han Jung  ;  Hye Sun Lee  ;  Seong Hwan Ahn  ;  Dong Hoon Shin  ;  Hye-Yeon Choi  ;  Han-Jin Cho  ;  Jang-Hyun Baek  ;  Gyu Sik Kim  ;  Kwon-Duk Seo  ;  Seo Hyun Kim  ;  Tae-Jin Song  ;  Jinkwon Kim  ;  Sang Won Han  ;  Joong Hyun Park  ;  Suk Ik Lee  ;  Joon Nyung Heo  ;  Hyung Woo Lee  ;  Il Hyung Lee  ;  Minyoul Baik  ;  Ji Hoe Heo 
Citation
 STROKE, Vol.53(12) : 3622-3632, 2022-12 
Journal Title
STROKE
ISSN
 0039-2499 
Issue Date
2022-12
MeSH
Cohort Studies ; Female ; Glomerular Filtration Rate ; Humans ; Ischemic Stroke* ; Kidney / physiology ; Male ; Reperfusion ; Risk Factors ; Stroke* / epidemiology
Keywords
glomerular filtration rate ; ischemic stroke ; mortality ; reperfusion ; thrombectomy
Abstract
Background: A high and low estimated glomerular filtration rate (eGFR) could affect outcomes after reperfusion therapy for ischemic stroke. This study aimed to determine whether renal function based on eGFR affects mortality risk in patients with ischemic stroke within 6 months following reperfusion therapy.

Methods: This prospective registry-based cohort study included 2266 patients who received reperfusion therapy between January 2000 and September 2019 and were registered in the SECRET (Selection Criteria in Endovascular Thrombectomy and Thrombolytic Therapy) study or the Yonsei Stroke Cohort. A high and low eGFR were based on the Chronic Kidney Disease Epidemiology Collaboration equation and defined, respectively, as the 5th and 95th percentiles of age- and sex-specific eGFR. Occurrence of death within 6 months was compared among the groups according to their eGFR such as low, normal, or high eGFR.

Results: Of the 2266 patients, 2051 (90.5%) had a normal eGFR, 110 (4.9%) a low eGFR, and 105 (4.6%) a high eGFR. Patients with high eGFR were younger or less likely to have hypertension, diabetes, or atrial fibrillation than the other groups. Active cancer was more prevalent in the high-eGFR group. During the 6-month follow-up, there were 24 deaths (22.9%) in the high-eGFR group, 37 (33.6%) in the low-eGFR group, and 237 (11.6%) in the normal-eGFR group. After adjusting for variables with P<0.10 in the univariable analysis, 6-month mortality was independently associated with high eGFR (hazard ratio, 2.22 [95% CI, 1.36-3.62]; P=0.001) and low eGFR (HR, 2.29 [95% CI, 1.41-3.72]; P=0.001). These associations persisted regardless of treatment modality or various baseline characteristics.

Conclusions: High eGFR as well as low eGFR were independently associated with 6-month mortality after reperfusion therapy. Kidney function could be considered a prognostic factor in patients with ischemic stroke after reperfusion therapy.
Full Text
https://www.ahajournals.org/doi/10.1161/STROKEAHA.122.039129
DOI
10.1161/STROKEAHA.122.039129
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Jinkwon(김진권) ORCID logo https://orcid.org/0000-0003-0156-9736
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Baik, Minyoul(백민렬)
Yoo, Joon Sang(유준상) ORCID logo https://orcid.org/0000-0003-1169-6798
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
Lee, Ilhyung(이일형)
Lee, Hyung Woo(이형우)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Jung, Yo Han(정요한) ORCID logo https://orcid.org/0000-0002-3048-4718
Heo, JoonNyung(허준녕)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193010
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