Takeaway
- In patients with chronic kidney disease (CKD), prior stroke was independently associated with several adverse clinical outcomes including death, reaching end-stage renal disease (ESRD) and suffering another non-fatal cardiovascular event.
Why this matters
- Findings highlight the importance of primary and secondary preventive measures to improve outcomes in CKD patients with prior stroke.
Study design
- Study of 3060 patients (aged ≥18 years) with all-cause non-dialysis CKD and prior stroke.
- Outcome: risks for death, non-fatal cardiovascular events (NFCVE) and end-stage renal disease (ESRD)
- Funding: None.
Key results
- In all, 277 (9.1%) patients had a history of stroke.
- At recruitment, patients with prior stroke vs those without had a significant increase in frequencies of:
- incident stroke (8.8% vs 2.9%; P<.01),
- myocardial infarction (10.6% vs 5.4%; P<.01),
- all NFCVE (26.4% vs 11.3%; P<.01),
- reaching ESRD (40.5% vs 31.3%; P<.01) and
- all-cause mortality (69.2% vs 45%; P<.01).
- At recruitment, prior stroke was independently associated with:
- mortality (HR, 1.20; 95% CI, 1.0-1.43; P=.05),
- ESRD (HR, 1.34; 95% CI, 1.06-1.69; P=.02) and
- future NFCVE (HR, 1.54; 95% CI, 1.12-2.11; P=.01).
- Patients with prior stroke at dialysis commencement vs those without had a significantly higher all-cause mortality (65% vs 49%; HR, 1.46; 95% CI, 1.006-2.14; P=.047).
Limitations
- Lack of data on stroke severity.
- Study predominantly included Caucasian population.
References
References
