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

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry

第一作者：Yilun Zhou,Dongxue Wang

通讯作者：Fan Fan Hou,Yongjun Wang

Acute kidney disease Stroke Incidence Prognosis Mortality

基本信息

2022-05-18

已发表文章

发表杂志：BMC Nephrology

发表类型: Research Article

影响因子(IF): 2.585

PMID: 35585568 Pubmed原文链接 全文下载

主要研究背景及目的

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).

方法

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.

结论

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.

主要结果

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.