Key result
Both high and low eGFR are linked to ~2.2-fold higher 6-month mortality after stroke reperfusion.
Why the study?
The impact of high and low estimated glomerular filtration rate on mortality risk after reperfusion therapy for ischemic stroke was uncertain.
Cohort (n=2,266)
Yes
Answers are grounded in this paper and cite their sources.
Both high and low eGFR were associated with higher 6-month mortality after reperfusion; leaves open whether renal function should inform risk stratification in ischemic stroke.
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.
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Park et al. (2022) conducted a cohort in Ischemic stroke (n=2,266). High estimated glomerular filtration rate (eGFR) vs. Normal eGFR was evaluated on Death within 6 months (HR 2.22, 95% CI 1.36-3.62, p=0.001). Both high eGFR and low eGFR were independently associated with increased 6-month mortality after stroke reperfusion therapy.
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