Background
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.
Methods
We 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.
Results
Patients 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.
Conclusions
Renal 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.
Key Words
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Article info
Publication history
Published online: October 25, 2016
Accepted:
September 22,
2016
Received in revised form:
September 9,
2016
Received:
July 12,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.037
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
