Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry

Yilun Zhou; Dongxue Wang; Hao Li; Yuesong Pan; Xianglong Xiang; Yu Wu; Xuewei Xie; Xianwei Wang; Yang Luo; Xia Meng; Jinxi Lin; Hong Wang; Yong Huo; Kunihiro Matsushita; Jing Chen; Fan Fan Hou; Yongjun Wang

doi:10.1186/s12882-022-02817-4

Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry

Yilun Zhou
, Dongxue Wang
, Hao Li
, Yuesong Pan
, Xianglong Xiang
, Yu Wu
, Xuewei Xie
, Xianwei Wang
, Yang Luo
, Xia Meng
, Jinxi Lin
, Hong Wang
, Yong Huo
, Kunihiro Matsushita
, Jing Chen
, Fan Fan Hou
, Yongjun Wang

Nuclear Dynamics and Cancer (NDC)

Capital Medical University
Temple University
Peking University
Johns Hopkins University
Tulane University
Southern Medical University
Guangzhou Regenerative Medicine and Health Guangdong Laboratory

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Background: Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease requiring a global strategy to address. The present study aimed to explore the impact of AKD on the prognosis of ischemic stroke. Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide registry of ischemic stroke or transient ischemic attack between August 2015 and March 2018. As a subgroup of CNSR-III, the patients who had serum creatinine (sCr) and serum cystatin C (sCysC) centrally tested on admission and at 3-month, and with 1-year follow-up data were enrolled. Modified AKD criteria were applied to identify patients with AKD during the first 3 months post stroke according to the guidelines developed by the Kidney Disease: Improving Global Outcomes in 2012. The primary clinical outcome was 1-year all-cause death, and secondary outcomes were stroke recurrence and post stroke disability. Results: Five thousand sixty-five patients were recruited in the study. AKD was identified in 3.9%, 6.7%, 9.9% and 6.2% of the patients by using sCr, sCr-based estimated glomerular filtration rate (eGFR_sCr), sCysC-based eGFR (eGFR_sCysC), and combined sCr and sCysC-based eGFR (eGFR_sCr+sCysC) criteria, respectively. AKD defined as sCr or eGFR_sCr criteria significantly increased the risk of all-cause mortality (adjusted HR 2.67, 95% CI: 1.27–5.61; adjusted HR 2.19, 95% CI: 1.17–4.10) and post stroke disability (adjusted OR 1.60, 95% CI: 1.04–2.44; adjusted OR 1.51, 95% CI: 1.08–2.11). AKD diagnosed by eGFR_sCysC or eGFR_sCr+sCysC criteria had no significant impact on the risk of all-cause death and post stroke disability. AKD, defined by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model. Conclusions: AKD, diagnosed by sCr or eGFR_sCr criteria, were independently associated with 1-year all-cause death and post stroke disability in Chinese ischemic stroke patients.

Original language	English
Article number	188
Pages (from-to)	188
Journal	BMC Nephrology
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s12882-022-02817-4
State	Published - Apr 18 2022

Keywords

Acute Disease
Biomarkers
China/epidemiology
Glomerular Filtration Rate
Humans
Ischemic Stroke
Kidney Diseases
Prognosis
Registries
Stroke/diagnosis

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10.1186/s12882-022-02817-4

Cite this

Zhou, Y., Wang, D., Li, H., Pan, Y., Xiang, X., Wu, Y., Xie, X., Wang, X., Luo, Y., Meng, X., Lin, J., Wang, H., Huo, Y., Matsushita, K., Chen, J., Hou, F. F., & Wang, Y. (2022). Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry. BMC Nephrology, 23(1), 188. Article 188. https://doi.org/10.1186/s12882-022-02817-4

@article{e8faac69989f4865928b9e43c63da94e,

title = "Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry",

abstract = "Background: Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease requiring a global strategy to address. The present study aimed to explore the impact of AKD on the prognosis of ischemic stroke. Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide registry of ischemic stroke or transient ischemic attack between August 2015 and March 2018. As a subgroup of CNSR-III, the patients who had serum creatinine (sCr) and serum cystatin C (sCysC) centrally tested on admission and at 3-month, and with 1-year follow-up data were enrolled. Modified AKD criteria were applied to identify patients with AKD during the first 3 months post stroke according to the guidelines developed by the Kidney Disease: Improving Global Outcomes in 2012. The primary clinical outcome was 1-year all-cause death, and secondary outcomes were stroke recurrence and post stroke disability. Results: Five thousand sixty-five patients were recruited in the study. AKD was identified in 3.9\%, 6.7\%, 9.9\% and 6.2\% of the patients by using sCr, sCr-based estimated glomerular filtration rate (eGFRsCr), sCysC-based eGFR (eGFRsCysC), and combined sCr and sCysC-based eGFR (eGFRsCr+sCysC) criteria, respectively. AKD defined as sCr or eGFRsCr criteria significantly increased the risk of all-cause mortality (adjusted HR 2.67, 95\% CI: 1.27–5.61; adjusted HR 2.19, 95\% CI: 1.17–4.10) and post stroke disability (adjusted OR 1.60, 95\% CI: 1.04–2.44; adjusted OR 1.51, 95\% CI: 1.08–2.11). AKD diagnosed by eGFRsCysC or eGFRsCr+sCysC criteria had no significant impact on the risk of all-cause death and post stroke disability. AKD, defined by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model. Conclusions: AKD, diagnosed by sCr or eGFRsCr criteria, were independently associated with 1-year all-cause death and post stroke disability in Chinese ischemic stroke patients.",

keywords = "Acute Disease, Biomarkers, China/epidemiology, Glomerular Filtration Rate, Humans, Ischemic Stroke, Kidney Diseases, Prognosis, Registries, Stroke/diagnosis",

author = "Yilun Zhou and Dongxue Wang and Hao Li and Yuesong Pan and Xianglong Xiang and Yu Wu and Xuewei Xie and Xianwei Wang and Yang Luo and Xia Meng and Jinxi Lin and Hong Wang and Yong Huo and Kunihiro Matsushita and Jing Chen and Hou, \{Fan Fan\} and Yongjun Wang",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = apr,

day = "18",

doi = "10.1186/s12882-022-02817-4",

language = "English",

volume = "23",

pages = "188",

journal = "BMC Nephrology",

issn = "1471-2369",

publisher = "BioMed Central Ltd.",

number = "1",

}

TY - JOUR

T1 - Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry

AU - Zhou, Yilun

AU - Wang, Dongxue

AU - Li, Hao

AU - Pan, Yuesong

AU - Xiang, Xianglong

AU - Wu, Yu

AU - Xie, Xuewei

AU - Wang, Xianwei

AU - Luo, Yang

AU - Meng, Xia

AU - Lin, Jinxi

AU - Wang, Hong

AU - Huo, Yong

AU - Matsushita, Kunihiro

AU - Chen, Jing

AU - Hou, Fan Fan

AU - Wang, Yongjun

PY - 2022/4/18

Y1 - 2022/4/18

N2 - Background: Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease requiring a global strategy to address. The present study aimed to explore the impact of AKD on the prognosis of ischemic stroke. Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide registry of ischemic stroke or transient ischemic attack between August 2015 and March 2018. As a subgroup of CNSR-III, the patients who had serum creatinine (sCr) and serum cystatin C (sCysC) centrally tested on admission and at 3-month, and with 1-year follow-up data were enrolled. Modified AKD criteria were applied to identify patients with AKD during the first 3 months post stroke according to the guidelines developed by the Kidney Disease: Improving Global Outcomes in 2012. The primary clinical outcome was 1-year all-cause death, and secondary outcomes were stroke recurrence and post stroke disability. Results: Five thousand sixty-five patients were recruited in the study. AKD was identified in 3.9%, 6.7%, 9.9% and 6.2% of the patients by using sCr, sCr-based estimated glomerular filtration rate (eGFRsCr), sCysC-based eGFR (eGFRsCysC), and combined sCr and sCysC-based eGFR (eGFRsCr+sCysC) criteria, respectively. AKD defined as sCr or eGFRsCr criteria significantly increased the risk of all-cause mortality (adjusted HR 2.67, 95% CI: 1.27–5.61; adjusted HR 2.19, 95% CI: 1.17–4.10) and post stroke disability (adjusted OR 1.60, 95% CI: 1.04–2.44; adjusted OR 1.51, 95% CI: 1.08–2.11). AKD diagnosed by eGFRsCysC or eGFRsCr+sCysC criteria had no significant impact on the risk of all-cause death and post stroke disability. AKD, defined by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model. Conclusions: AKD, diagnosed by sCr or eGFRsCr criteria, were independently associated with 1-year all-cause death and post stroke disability in Chinese ischemic stroke patients.

AB - Background: Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease requiring a global strategy to address. The present study aimed to explore the impact of AKD on the prognosis of ischemic stroke. Methods: The Third China National Stroke Registry (CNSR-III) was a nationwide registry of ischemic stroke or transient ischemic attack between August 2015 and March 2018. As a subgroup of CNSR-III, the patients who had serum creatinine (sCr) and serum cystatin C (sCysC) centrally tested on admission and at 3-month, and with 1-year follow-up data were enrolled. Modified AKD criteria were applied to identify patients with AKD during the first 3 months post stroke according to the guidelines developed by the Kidney Disease: Improving Global Outcomes in 2012. The primary clinical outcome was 1-year all-cause death, and secondary outcomes were stroke recurrence and post stroke disability. Results: Five thousand sixty-five patients were recruited in the study. AKD was identified in 3.9%, 6.7%, 9.9% and 6.2% of the patients by using sCr, sCr-based estimated glomerular filtration rate (eGFRsCr), sCysC-based eGFR (eGFRsCysC), and combined sCr and sCysC-based eGFR (eGFRsCr+sCysC) criteria, respectively. AKD defined as sCr or eGFRsCr criteria significantly increased the risk of all-cause mortality (adjusted HR 2.67, 95% CI: 1.27–5.61; adjusted HR 2.19, 95% CI: 1.17–4.10) and post stroke disability (adjusted OR 1.60, 95% CI: 1.04–2.44; adjusted OR 1.51, 95% CI: 1.08–2.11). AKD diagnosed by eGFRsCysC or eGFRsCr+sCysC criteria had no significant impact on the risk of all-cause death and post stroke disability. AKD, defined by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model. Conclusions: AKD, diagnosed by sCr or eGFRsCr criteria, were independently associated with 1-year all-cause death and post stroke disability in Chinese ischemic stroke patients.

KW - Acute Disease

KW - Biomarkers

KW - China/epidemiology

KW - Glomerular Filtration Rate

KW - Humans

KW - Ischemic Stroke

KW - Kidney Diseases

KW - Prognosis

KW - Registries

KW - Stroke/diagnosis

UR - https://www.scopus.com/pages/publications/85130249706

U2 - 10.1186/s12882-022-02817-4

DO - 10.1186/s12882-022-02817-4

M3 - Article

C2 - 35585568

AN - SCOPUS:85130249706

SN - 1471-2369

VL - 23

SP - 188

JO - BMC Nephrology

JF - BMC Nephrology

IS - 1

M1 - 188

ER -

Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry

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