Chronic kidney disease is prevalent in Chinese patients admitted with verified cerebrovascular lesions and predicts short-term prognosis

Abstract

Objective. Recent studies have identified chronic kidney disease (CKD) as an important risk factor for vasculopathies. While the link between CKD and cardiovascular events is well established, the link with cerebrovascular lesions (CVL) has been less well described.Methods. We studied the prevalence and prognostic importance of CKD in 1014 incident Chinese patients admitted with verified computerized tomography (CT) or magnetic resonance imaging (MRI) CVL (within the last 7 days). Laboratory data included the urinary microalbumin-to-creatinine ratio, routine urinalysis, fasting plasma glucose, serum creatinine, uric acid and other measures. Estimated glomerular filtration rate was calculated (using the modification of diet in renal disease formula) and CKD stages were classified according to kidney disease outcome quality initiative (K/DOQI) guidelines. Patients were followed for 30 days and any neurological sequelae were recorded.Results. A total of 1014 patients were enrolled (455 females, aged 68.56 ±12.17 years). Among these, 708 had ischemic stroke, 197 hemorrhagic stroke and 109 had transient cerebral ischemic attack. Microalbuminuria was detected in 11.2% of patients, while 24.8% had proteinuria. Of all patients, 6.90% had Stage 1, 14.69% Stage 2, 21.60% Stage 3, 2.56% Stage 4 and 1.97% had Stage 5, giving a total prevalence of CKD at 47.7%. In logistic regression, proteinuria (odds ratio = 1.69), hyperglycemia (odds ratio = 1.67) and anemia (odds ratio = 1.37) were independent predictors for risk of sequelae at 30 days for both ischemic and non-ischemic CVL.Conclusion. We report a high prevalence of CKD among Chinese patients with incident CVL. Proteinuria, hyperglycemia and anemia were prognostic factors in these patients. © 2011 The Author Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.