国家神经系统疾病临床医学研究中心数据管理与共享系统

发表杂志：Ann Transl Med

发表类型: Original Contributions

影响因子(IF): 3.932

PMID: 32055593 Pubmed原文链接 全文下载

In China, stroke is the leading cause of death and disability. Several risk factors are closely related with the poor outcome of stroke, thereinto chronic kidney disease (CKD) is a common independent risk factor and comorbidity for stroke.For most of CKD, anemia is highly prevalent and known as an intermediate marker of CKD; what’s more, anemia is regarded as a strong independent predictor of the increased mortality with stroke3. The study on the community-based population demonstrated that CKD combined with anemia was significantly associated with the increased risk of stroke4. For the stroke patients, the presence of CKD and anemia also predicted the high risk of mortality in1-year follow-up5；however，these included patients were first-ever, and the outcome of stroke affected by the joint effect of CKD and anemia was not testified in this cohort study. Herein, we hypothesized that modest or severe kidney dysfunction patients (eGFR ＜60 mL/min per 1.73 m2) with the presence of anemia had more strong association with the poor clinical outcome for after acute ischemic stroke, compared to those without anemia. We tested this assumption by estimating the relationship between kidney function and the outcome of acute ischemic stroke in the presence or not of anemia.

Data of patients with acute ischemic stroke in the prospective cohort study of China National Stroke Registry was reviewed. According to the levels of eGFR and hemoglobin, patients were categorized into four groups: low eGFR (<60 mL/min per 1.73 m2) or normal eGFR (≥60 mL/min per 1.73 m2) with or without anemia. Multivariate logistic regression methods were used to analyze the association between eGFR with or without anemia and outcomes after stroke [the poor functional outcome (modified Rankin Scale, mRS 3–6), mortality and stroke recurrence] at 3 months and 1 year.