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Renal Impairment and Risk of Acute Stroke: The INTERSTROKE Study.

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dc.contributor.author Smyth, Andrew
dc.contributor.author Judge, Conor
dc.contributor.author Wang, Xingu
dc.contributor.author Pare, Guillaume
dc.contributor.author Rangarajan, Sumathy
dc.contributor.author Canavan, Michelle
dc.contributor.author Chin, Siu Lim
dc.contributor.author Al-Hussain, Fawaz
dc.contributor.author Yusufali, Afzalhussein M.
dc.contributor.author Elsayed, Ahmed
dc.contributor.author Damasceno, Albertino
dc.contributor.author Avezum, Alvaro
dc.contributor.author Czlonkowska, Anna
dc.contributor.author Rosengren, Annika
dc.contributor.author Dans, Antonio L.
dc.contributor.author Oguz, Aytekin
dc.contributor.author Mondo, Charles
dc.contributor.author Weimar, Christian
dc.contributor.author Ryglewicz, Danuta
dc.contributor.author Xavier, Denis
dc.contributor.author Lanas, Fernando
dc.contributor.author Málaga Rodríguez, Germán Javier
dc.contributor.author Hankey, Graeme J.
dc.contributor.author Iversen, Helle K.
dc.contributor.author Zhang, Hongye
dc.contributor.author Yusoff, Khalid
dc.contributor.author Pogosova, Nana
dc.contributor.author Lopez-Jamarillo, Patricio
dc.contributor.author Langhorne, Peter
dc.contributor.author Diaz, Rafael
dc.contributor.author Oveisgharan, Shahram
dc.contributor.author Yusuf, Salim
dc.contributor.author O'Donnell, Martin
dc.date.accessioned 2021-05-18T21:44:17Z
dc.date.available 2021-05-18T21:44:17Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9399
dc.description.abstract BACKGROUND: Previous studies reported an association of renal impairment with stroke, but there are uncertainties underpinning this association. AIMS: We explored if the association is explained by shared risk factors or is independent and whether there are regional or stroke subtype variations. METHODS: INTERSTROKE is a case-control study and the largest international study of risk factors for first acute stroke, completed in 27 countries. We included individuals with available serum creatinine values and calculated estimated glomerular filtration rate (eGFR). Renal impairment was defined as eGFR <60 mL/min/1.73 m2. Multivariable conditional logistic regression was used to determine the association of renal function with stroke. RESULTS: Of 21,127 participants, 41.0% were female, the mean age was 62.3 ± 13.4 years, and the mean eGFR was 79.9 ± 23.5 mL/min/1.73 m2. The prevalence of renal impairment was higher in cases (22.9% vs. 17.7%, p < 0.001) and differed by region (p < 0.001). After adjustment, lower eGFR was associated with increased odds of stroke. Renal impairment was associated with increased odds of all stroke (OR 1.35; 95% CI: 1.24-1.47), with higher odds for intracerebral hemorrhage (OR 1.60; 95% CI: 1.35-1.89) than ischemic stroke (OR 1.29; 95% CI: 1.17-1.42) (pinteraction 0.12). The largest magnitudes of association were seen in younger participants and those living in Africa, South Asia, or South America (pinteraction < 0.001 for all stroke). Renal impairment was also associated with poorer clinical outcome (RRR 2.97; 95% CI: 2.50-3.54 for death within 1 month). CONCLUSION: Renal impairment is an important risk factor for stroke, particularly in younger patients, and is associated with more severe stroke and worse outcomes en_US
dc.language.iso eng
dc.publisher Karger
dc.relation.ispartofseries Neuroepidemiology
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Kidney disease en_US
dc.subject Stroke en_US
dc.title Renal Impairment and Risk of Acute Stroke: The INTERSTROKE Study. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1159/000515239
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.09
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.25
dc.relation.issn 1423-0208


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