Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry
First author：Yilun Zhou,Dongxue Wang
Corresponding author：Fan Fan Hou,Yongjun Wang
essential_information
- Person in charge：Yilun Zhou,Dongxue Wang
- Data Sources： CNSR-Ⅲ
- Number of papers：CNSR-Ⅲ20190262
- Published time：2022-05-18
2022-05-18
Published articles
Journal：BMC Nephrology
Publication type: Research Article
IF(IF): 2.585
PMID: 35585568 Link To Pubmed Full text Download
Background And Purpose
Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease which might not fulfill strict criteria for AKI or CDK, but still require medical attention to avoid adverse outcomes. Up to now, only two clinical studies have attempted to characterize AKD. Therefore we investigated the clinical characteristics and prognosis of AKD in the China National Stroke Registry III (CNSR III).
Method
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. Modifed AKD criteria were applied to identify patients with AKD during the frst 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.
Conclusion
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.
Main results
Five thousand sixty-fve patients were recruited in the study. AKD was identifed in 3.9%, 6.7%, 9.9% and 6.2% of the patients by using sCr, sCr-based estimated glomerular fltration rate (eGFRsCr), sCysC-based eGFR (eGFRsCysC), and combined sCr and sCysC-based eGFR (eGFRsCr+sCysC) criteria, respectively. AKD defned as sCr or eGFRsCr criteria signifcantly 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 signifcant impact on the risk of all-cause death and post stroke disability. AKD, defned by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model.