scholarly journals Mechanisms of Stroke in Patients with Chronic Kidney Disease

2019 ◽  
Vol 50 (4) ◽  
pp. 229-239 ◽  
Author(s):  
Shivani Ghoshal ◽  
Barry I. Freedman
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Cerebral Perfusion ◽  
Treatment Options ◽  
Vascular Complications ◽  
Neurovascular Coupling ◽  
Brain Perfusion ◽  
Care Practice ◽  
Increased Risk

Background: Given the increasing worldwide prevalence of chronic kidney disease (CKD), it is critical to decrease the associated risk of debilitating vascular complications, including stroke, congestive heart failure, myocardial infarction, and peripheral vascular disease. Treatment options for reducing the risk of all subtypes of stroke in patients with CKD remain limited. For patients with end-stage kidney disease (ESKD), novel applications of noninvasive imaging may help personalize the type of dialysis and dialysis prescription for patients at high-risk. Summary: This manuscript reviews the heightened risk of stroke in patients with nephropathy, including ischemic and hemorrhagic subtypes. Mechanisms associated with increased risk include alterations in cardiac output, platelet function, regional cerebral perfusion, accelerated systemic atherosclerosis, altered blood brain barrier, and disordered neurovascular coupling. There is great potential for noninvasive monitoring of the cerebral vasculature using transcranial Doppler (TCD) to reduce stroke risk, particularly in patients with ESKD. Key Messages: Compared to the general population, patients with CKD are at heightened risk for all subtypes of stroke. This is due to a multitude of mechanisms linking nephropathy with altered cerebral perfusion, cerebral neurovascular coupling, and blood vessel integrity. Intracranial imaging is not currently standard of care practice in patients with CKD or ESKD. TCD may provide clinicians real-time and noninvasive measurement of brain perfusion. This could be useful for assessing risk of stroke in patients’ initiating dialysis, individualizing dialysis prescriptions, and potentially reducing rates of cerebrovascular disease and stroke in high-risk patients.

scholarly journals Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Demetria Hubbard ◽  
Lisandro D. Colantonio ◽  
Robert S. Rosenson ◽  
Todd M. Brown ◽  
Elizabeth A. Jackson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
High Risk ◽  
Kidney Disease ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Very High

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

MO817ALDOSTERONE ANTAGONISTS FOR PATIENTS WITH CHRONIC KIDNEY DISEASE REQUIRING DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Takeshi Hasegawa ◽  
Hiroki Nihiwaki ◽  
Erika Ota ◽  
William Levack ◽  
Hisashi Noma
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Standard Care ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Aldosterone Antagonists ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background and Aims Patients with chronic kidney disease (CKD) undergoing dialysis are at a particularly high risk of cardiovascular mortality and morbidity. This systematic review and meta-analysis aimed to evaluate the benefits and harms of aldosterone antagonists, both non-selective (spironolactone) and selective (eplerenone), in comparison to control (placebo or standard care) in patients with CKD requiring haemodialysis or peritoneal dialysis. Method We searched the Cochrane Kidney and Transplant Register of Studies up to 29 July 2019 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register Search Portal and ClinicalTrials.gov. We included individual and cluster randomised controlled trials (RCTs), cross-over trials, and quasi-RCTs that compared aldosterone antagonists with placebo or standard care in patients with CKD requiring dialysis. We used a random-effects model meta-analysis to perform a quantitative synthesis of the data. We used the I2 statistic to measure heterogeneity among the trials in each analysis. We indicated summary estimates as a risk ratio (RR) for dichotomous outcomes with their 95% confidence interval (CI). We assessed the certainty of the evidence for each of the main outcomes using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach. Results We included 16 trials (14 parallel RCTs and two cross-over trials) involving a total of 1,446 patients. Among included studies, 13 trials compared spironolactone to placebo or standard care and one trial compared eplerenone to a placebo. Most studies had an unclear or high risk of bias. Compared to control, aldosterone antagonists reduced the risk of all-cause death for patients with CKD requiring dialysis (9 trials, 1,119 patients: RR 0.45, 95% CI 0.30 to 0.67; moderate certainty of evidence). Aldosterone antagonist also decreased the risk of death due to cardiovascular disease (6 trials, 908 patients: RR 0.37, 95% CI 0.22 to 0.64; moderate certainty of evidence) and cardiovascular and cerebrovascular morbidity (3 trials, 328 patients: RR 0.38, 95% CI 0.18 to 0.76; moderate certainty of evidence). While aldosterone antagonists had an apparent increased risk of gynaecomastia compared with control (4 trials, 768 patients: RR 5.95, 95% CI 1.93 to 18.3; moderate certainty of evidence), the elevated risk of hyperkalaemia due to aldosterone antagonists was uncertain (9 trials, 981 patients: RR 1.41, 95% CI 0.72 to 2.78; low certainty of evidence). Conclusion Based on moderate certainty of the evidence, aldosterone antagonists could reduce the risk of all-cause and cardiovascular death and morbidity due to cardiovascular and cerebrovascular disease but increase the risk of gynaecomastia in patients with CKD requiring dialysis.

scholarly journals P0255THE SHORT TERM MATERNAL OUTCOME OF PREGNANT CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Christopher thiam seong Lim ◽  
Yun Jin Ong ◽  
Shao Wei Yong ◽  
Wee Ven Hing [email protected] ◽  
Mohammad Zulkarnain Bidin ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Blood Pressure Monitoring ◽  
Post Partum ◽  
Antibiotic Usage ◽  
High Risk Population ◽  
Multiple Pregnancies ◽  
Fetal Outcomes ◽  
Increased Risk

Abstract Background and Aims Pregnancy in chronic kidney disease (CKD) is associated with increased risk of adverse maternal outcomes and fetal outcomes. The risks are noticeable even in early stages of CKD. Despite the rising concern, there are few follow-up studies in this high-risk group. Method We followed up and analysed 538 pregnancies in 173 women with pre-existing of primary renal disease who were seen at a tertiary nephrology centre from January 2007 until December 2015. We sought to investigate the changes in laboratory and clinical parameters, maternal and fetal outcomes. Results Figure 1 showed the changes of parameters intra and post-partum period. Increase in weight (p=0.034, OR 1.135, 95% CI 1.01-1.276), antibiotics consumption (p=0.022, OR 0.088, 95% CI 0.011-0.0703), pregnancy-related hypertension (p=0.056, OR 0.161, 95% CI 0.025-1.05) and gromerulonephritis (p=0.049, OR 14.22, 95% CI 1.009- 200.52) were associated with worsening of proteinuria intra-pregnancy and post-pregnancy period. Age more than 30-year-old (p=0.024, OR 0.644, 95% CI 0.439-0.945), multiple pregnancies (p = 0.032, OR 14.4, 95% CI 1.25-165 , antibiotics usage (p=0.033, OR 27.59, 95% CI 1.302-585.169), diuretic usage (p=0.034, OR 0.003, 95% CI 1.26-0.646), pregnancy-related hypertension (p=0.06, OR 21.838, 95% CI 0.878-543.376) and proteinuria (> 1.5g/d) (p=0.025, OR 0.235 95% CI 0.067-0.717) and fetal complications such as fetal death (p=0.013, OR 3.608 95% CI 1.311-9.930) was associated with rapid renal function decline of 25-50% . Elevation of serum uric acid is associated with a higher risk of adverse fetal outcome (r=0.845 p=0.004). Conclusion Multiple pregnancies, antibiotic usage, pregnancy-related hypertension are strong predictors of rapid maternal rapid function decline. Pre-conception counselling, minimization of antibiotic usage and aggressive blood pressure monitoring and treatment should be part of the standard treatment for this high-risk population.

scholarly journals Diet Beverage Intake and Risk of Chronic Kidney Disease in People with Type 2 Diabetes: An Individual Level Meta-Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1467-1467
Author(s):  
Andrew Odegaard ◽  
David Jacobs ◽  
Lyn Steffen ◽  
Casey Rebholz ◽  
Katherine Tucker ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Healthy Eating Index ◽  
Cardiovascular Health Study ◽  
Individual Level ◽  
Increased Risk

Abstract Objectives Diet beverages are calorie free beverages sweetened with non-nutritive sweeteners. People with diabetes are the highest per-capita consumers of diet beverages, tending to consume them as a replacement for sugar sweetened beverages. This behavior is endorsed by dietetic and scientific organizations and diet beverages are marketed synonymously with better health. The underlying concern is the lack of data to support or refute this concept. To begin addressing this gap we examined the association between diet beverage intake and incident chronic kidney disease (CKD) in a population at high risk for CKD. Methods We pooled data from the Atherosclerosis Risk in Communities study (years 1987–2014), Cardiovascular Health Study (1989–2014), Jackson Heart Study (2000–2012), and Multi-Ethnic Study of Atherosclerosis (2000–2013) to conduct a prospective study of the association of diet beverage intake with the incidence of CKD among participants with clinically ascertained type 2 diabetes (T2D) without prevalent CKD and with valid dietary data (n = 3250). CKD was defined using serum creatinine to define estimated glomerular filtration (eGFR) via the CKD-EPI creatinine equation. Incident CKD was defined as (eGFR <60 ml/min/1.73 m2). We carried out a 2-step meta-analysis using individual level, cohort-specific regression analyses with identical adjustment for demographic, lifestyle, overall diet quality (Alternative Healthy Eating Index), energy intake, and clinical risk factors (baseline eGFR, total cholesterol, blood pressure, fasting glucose) to generate effect estimates that were pooled together using fixed and random effects meta-analysis. Results 1018 participants developed CKD during follow-up. There was a positive association between diet beverage intake and risk of CKD. Compared to individuals reporting no intake of diet beverages, those consuming >0 and <1 diet beverage per day had a pooled relative risk and 95% confidence interval (RR, 95% CI) of 1.03 (0.87–1.22) and those consuming ≥1 beverage per day had a pooled RR (95% CI) of 1.20 (1.02–1.41). Conclusions Diet beverage intake was associated with an increased risk of CKD in a diverse population with T2D. These results suggest the need to further examine the role of diet beverages in this high risk population. Funding Sources AHA.

scholarly journals Hospitalization Risk among Older Adults with Chronic Kidney Disease

2019 ◽  
Vol 50 (3) ◽  
pp. 212-220 ◽  
Author(s):  
Eugenia Wong ◽  
Shoshana H. Ballew ◽  
Natalie Daya ◽  
Junichi Ishigami ◽  
Casey M. Rebholz ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Cystatin C ◽  
Negative Binomial ◽  
Incidence Rates ◽  
Hospitalization Rates ◽  
Increased Risk ◽  
Very High

Introduction: Chronic kidney disease (CKD) risk staging is based on estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR). However, the relationship between all-cause hospitalization risk and the current CKD staging system has not been well studied among older adults, despite a high prevalence of CKD and a high risk of hospitalization in old age. Methods: Among 4,766 participants of the Atherosclerosis Risk in Communities study, CKD was staged according to Kidney Disease Improving Global Outcomes (KDIGO) criteria, using creatinine-based eGFR (eGFRcr) and ACR. Incidence rates of all-cause hospitalization associated with each CKD risk group were analyzed using negative binomial regression. Additionally, cause-specific hospitalization risks for cardiovascular, infectious, kidney, and other diseases were estimated. The impacts of using cystatin C-based eGFR (eGFRcys) to estimate the prevalence of CKD and risks of hospitalization were also quantified. Results: Participants experienced 5,548 hospitalizations and 29% had CKD. Hospitalization rates per 1,000 person-years according to KDIGO risk categories were 208–223 (“low risk”), 288–376 (“moderately increased risk”), 363–548 (“high risk”), and 499–1083 (“very high risk”). The increased risk associated with low eGFR and high ACR persisted in adjusted analyses, examinations of cause-specific hospitalizations, and when CKD was staged by eGFRcys or eGFRcr-cys, a combined equation based on both creatinine and cystatin C. In comparison to eGFRcr, staging by eGFRcys increased the prevalence of CKD to 50%, but hospitalization risks remained similarly high. Discussion/Conclusion: In older adults, decreased eGFR, increased ACR, and KDIGO risk stages based on a combination of these measures, were strong risk factors for hospitalization. These relationships were consistent, regardless of the marker used to estimate GFR, but the use of cystatin C resulted in a substantially higher prevalence of CKD than the use of creatinine. Older adults in the population with very high risk stages of CKD have hospitalization rates exceeding 500 per 1,000 person-years.

An analysis of the association between a polymorphism rs5219 of KCNJ11 and GFR in CKD development in patients with type 2 diabetes in Russian population

2016 ◽  
Vol 62 (5) ◽  
pp. 11-12
Author(s):  
Anna V. Zheleznyakova ◽  
Olga K. Vikulova ◽  
Svetlana A. Savelyeva ◽  
Valeriy V. Nosikov ◽  
Marina V. Shestakova
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Insulin Secretion ◽  
Kidney Disease ◽  
Potassium Channels ◽  
Vascular Complications ◽  
Damage Development ◽  
Kcnj11 Gene ◽  
Increased Risk

Background. Chronic kidney disease is one of the most serious diabetic complications, which end-stage leads to a dramatic decline of renal function and needs for renal replacement therapy. Due to the progressive nature of CKD and the limited efficacy of treatment for advanced stages the prediction of risks and diagnostics on preclinical stage are of great importance. All of the above determines the high relevance of search for genetic markers predict the chronic kidney disease (CKD) development.The aim of our study was to investigate association between polymorphic marker (PM) of gene involved in insulin secretion with development of CKD in type 2 diabetic (T2D) patients. Polymorphism of KCNJ11 gene is associated with different phenotypes of glycemic disorders: neonatal diabetes, hyperinsulinemia, reduced insulin secretion and increased risk of type 2 diabetes. This gene coding Kir6.2 subunit of ATP-dependent potassium channels. The pathogenesis of it’s involvement in renal damage development referred to the fact that this type of potassium channels found not only in the beta- cells, but also in smooth muscle cells of blood vessels, and therefore might have an effect on risk of vascular complications, including CKD.Materials and methods. We enrolled 444 T2D patients. PM rs5219 in KCNJ11 gene was analysed among patients divided in 2 groups: with and without CKD (n=123/321) based on glomerular filtration rate (GFR) < and ≥ 60 ml/min/1,73m2 calculated by MDRD formula. PM studied using PCR. Differences in alleles/genotypes frequencies were assessed by χ² and odds ratio (OR) were calculated. The study was approved by local ethical committee; informed concern was obtained from all the patients.Results. We studied the main clinical parameters: age, HbA1c, serum levels of cholesterol and triglycerides, BP between the groups. We observed significant differences in alleles/genotypes distribution of rs5219 in KCNJ11 gene between groups with and without CKD: the prevalence of allele C and genotype CC in patients without CKD: OR=0,53, 95%CI: 0,40-0,72 and OR=0,46, 95%CI: 0,27-0,79, respectively; while allele T and genotype TT did as risk factors: χ²=17,33; р=0,0002; OR=1,87, 95%CI: 1,39-2,53; genotype TT OR=2,39, 95%CI: 1,52-3,76.Conclusions. We conclude that T2D patients might have genetic susceptibility to CKD development caused by polymorphism rs5219 of KCNJ11 gene with protective role of allele C and genotype CC and risk allelе/genotype is T/TT.

scholarly journals Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 822
Author(s):  
Meng-Hao Lin ◽  
Su-Ju Lin ◽  
Liang-Tseng Kuo ◽  
Tien-Hsing Chen ◽  
Chi-Lung Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Shoulder Arthroplasty ◽  
Perioperative Outcomes ◽  
Hospital Death ◽  
Diabetic Patients ◽  
Superficial Infection ◽  
Subdistribution Hazard ◽  
Increased Risk

The number of diabetic patients with chronic kidney disease (CKD) undergoing shoulder arthroplasty is growing. This study aims to compare perioperative outcomes of shoulder arthroplasty in diabetic patients at different renal function stages. Between 1998 and 2013, a total of 4443 diabetic patients with shoulder arthroplasty were enrolled: 1174 (26%) had CKD without dialysis (CKD group), 427 (9%) underwent dialysis (dialysis group), and 3042 (68%) had no CKD (non-CKD group). Compared with the non-CKD group, the CKD (odds ratio [OR], 4.69; 95% confidence interval [CI], 2.02–10.89) and dialysis (OR, 6.71; 95% CI, 1.63–27.73) groups had a high risk of in-hospital death. The dialysis group had a high risk of infection after shoulder arthroplasty compared with the CKD (subdistribution hazard ratio [SHR], 1.69; 95% CI, 1.07–2.69) and non-CKD (SHR, 1.76; 95% CI, 1.14–2.73) groups. The dialysis group showed higher risks of all-cause readmission and mortality than the CKD and non-CKD groups after a 3-month follow-up. In conclusion, CKD was associated with worse outcomes after shoulder arthroplasty. Compared with those without CKD, CKD patients had significantly increased readmission and mortality risks but did not have an increased risk of surgical complications, including superficial infection or implant removal.

scholarly journals Risk of chronic kidney disease in patients with obstructive sleep apnea

SLEEP ◽  
2021 ◽  
Author(s):  
Andrew E Beaudin ◽  
Jill K Raneri ◽  
Sofia B Ahmed ◽  
A J Marcus Hirsch Allen ◽  
Andrhea Nocon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Kidney Disease ◽  
Ckd Progression ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Very High

Abstract Study Objectives Chronic kidney disease (CKD) is a global health concern and a major risk factor for cardiovascular morbidity and mortality. Obstructive sleep apnea (OSA) may exacerbate this risk by contributing to the development of CKD. This study investigated the prevalence and patient awareness of the risk of CKD progression in individuals with OSA. Methods Adults referred to five Canadian academic sleep centers for suspected OSA completed a questionnaire, a home sleep apnea test or in-lab polysomnography and provided blood and urine samples for measurement of estimated glomerular filtration rate (eGFR) and the albumin:creatinine ratio (ACR), respectively. The risk of CKD progression was estimated from a heat map incorporating both eGFR and ACR. Results 1295 adults (42% female, 54±13y) were categorized based on the oxygen desaturation index (4% desaturation): &lt;15 (no/mild OSA, n=552), 15-30 (moderate OSA, n=322), and &gt;30 (severe OSA, n=421). After stratification, 13.6% of the no/mild OSA group, 28.9% of the moderate OSA group, and 30.9% of the severe OSA group had a moderate-to-very high risk of CKD progression (p&lt;0.001), which was defined as an eGFR &lt; 60 mL/min/1.73m2, an ACR ≥3 mg/mmol, or both. Compared to those with no/mild OSA, the odds ratio for moderate-to-very high risk of CKD progression was 2.63 (95% CI: 1.79-3.85) for moderate OSA and 2.96 (2.04–4.30) for severe OSA after adjustment for CKD risk factors. Among patients at increased risk of CKD progression, 73% were unaware they had abnormal kidney function. Conclusion Patients with moderate and severe OSA have an increased risk of CKD progression independent of other CKD risk factors; most patients are unaware of this increased risk.

Boosting the Limited Use of Mineralocorticoid Receptor Antagonists Through New Agents for Hyperkalemia

2019 ◽  
Vol 24 (46) ◽  
pp. 5542-5547 ◽  
Author(s):  
Vasilios G. Athyros ◽  
Alexandros G. Sachinidis ◽  
Ioanna Zografou ◽  
Elisavet Simoulidou ◽  
Alexia Piperidou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Treatment Options ◽  
Sodium Polystyrene Sulfonate ◽  
Drug Induced ◽  
New Agents ◽  
Increased Risk ◽  
Raas Inhibitors ◽  
The Impact

Background: Hyperkalemia is an important clinical problem that is associated with significant lifethreatening complications. Several conditions are associated with increased risk for hyperkalemia such as chronic kidney disease, diabetes mellitus, heart failure, and the use of renin-angiotensin-aldosterone system (RAAS) inhibitors. Objective: The purpose of this review is to present and critically discuss treatment options for the management of hyperkalemia. Method: A comprehensive review of the literature was performed to identify studies assessing the drug-induced management of hyperkalemia. Results: The management of chronic hyperkalemia seems to be challenging and includes a variety of traditional interventions, such as restriction in the intake of the dietary potassium, loop diuretics or sodium polystyrene sulfonate. In the last few years, several new agents have emerged as promising options to reduce potassium levels in hyperkalemic patients. Patiromer and sodium zirconium cyclosilicate 9 (ZS-9) have been examined in hyperkalemic patients and were found to be efficient and safe. Importantly, the efficacy of these novel drugs might allow the continuation of the use of RAAS inhibitors, morbidity- and mortality-wise beneficial class of drugs in the setting of chronic kidney disease and heart failure. Conclusion: Data support that the recently emerged patiromer and ZS-9 offer significant hyperkalemia-related benefits. Larger trials are needed to unveil the impact of these drugs in other patients’ subpopulations, as well.

Stroke in chronic renal failure

2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Kidney Diseases ◽  
Cerebrovascular Diseases ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Intracerebral Hemorrhages

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.

Sign in / Sign up

Export Citation Format

Share Document