Association of glomerular filtration rate with outcomes of acute stroke in type 2 diabetic patients: results from the China National Stroke Registry.

TitleAssociation of glomerular filtration rate with outcomes of acute stroke in type 2 diabetic patients: results from the China National Stroke Registry.
Publication TypeJournal Article
Year of Publication2013
AuthorsLuo Y, Wang X, Wang Y, Wang C, Wang H, Wang D, Liu L, Jia Q, Liu G, Zhao X, Wang Y
Corporate Authorson behalf of the CNSR investigators
JournalDiabetes care
Date Published2013 Sep 5
Abstract

OBJECTIVEWe aim to explore whether a link exists between different levels of estimated glomerular filtration rate (eGFR) and poor outcomes of acute stroke in patients with type 2 diabetes.RESEARCH DESIGN AND METHODSBetween 2007 and 2009, 6261 patient with cerebrovascular events and diabetes were included in the final analysis from the China National Stroke Registry (CNSR) and substudy of CNSR (abnormal glucose regulation in patients with acute stroke across China, ACROSS).The period of follow-up was one year after stroke onset. eGFR was calculated with the Chinese modification of chronic kidney disease epidemiology collaboration (CKD-EPI) equation. The association between eGFR and poor stroke outcomes including all-cause death, recurrent stroke, combined endpoint (stroke or death) and stroke disability was evaluated by multivariate analysis with the adjustment for demographic and clinical features.RESULTSOf 4836 patients with stroke, low eGFR (< 45 ml/min/1.73m(2)) occurred in 268 (5.5%) and high eGFR (≥ 120 ml/min/1.73m(2)) in 387 (8.0%). The median value for eGFR in all patients was 92.6 ml/min/1.73m(2). Low eGFR was independently associated with risks of all of clinical outcomes in stroke/TIA patients or patients with ischemic events, but not in patients with the hemorrhagic stroke. Additionally, high eGFR was positively associated with an increased risk of adverse outcomes in all of stroke subtypes including hemorrhagic stroke.CONCLUSIONSLow and high eGFRs (<45 ml/min/1.73m(2) or ≥120 ml/min/1.73m(2), respectively) are independent predictors of all-cause mortality and other poor outcomes after acute stroke in patients with type 2 diabetes.

DOI10.1371/journal.pone.0073023
Alternate JournalDiabetes Care