Characteristics of acute ischemic stroke in patients with Nephrotic syndrome
The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on the specific characteristics to stroke patients with NS. In this study, we aimed to examine the clinical manifestations of acute IS in a large...
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Published in | Renal failure Vol. 45; no. 2; p. 2284214 |
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Abstract | The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on the specific characteristics to stroke patients with NS. In this study, we aimed to examine the clinical manifestations of acute IS in a large group of NS patients, comparing to those without NS. We conducted a retrospective cohort study to compare the clinical presentations of acute IS in patients with and without NS. This study was a multi-institutional study and used data from Chang Gung Research Database of Taiwan from 1 January 2001, to 31 December 2017. A total of 233 IS patients with NS and 1358 IS patients without NS were enrolled. The median age of participants was 68 (range: 59-79) years. The risk of dependent functional status (modified Rankin Scale score≧3) after IS was higher in NS patients compared to those without NS (Odd ratio (OR) 4.02, 95% confidence interval (CI) 2.39 to 6.76,
< 0.001), particularly in stroke subtypes as small-artery occlusion (OR 8.02, 95% CI 3.94 to 16.32,
< 0.001), and stroke of undetermined etiology (OR 2.47, CI 1.06 to 5.76,
= 037). The risks of mortality or stroke recurrence within 30 days were similar between the two groups for all stroke subtypes. In conclusion, NS was associated with a higher risk of functional dependence following IS. Intensive treatment and rehabilitation should be considered for IS patients with NS. |
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AbstractList | The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on the specific characteristics to stroke patients with NS. In this study, we aimed to examine the clinical manifestations of acute IS in a large group of NS patients, comparing to those without NS. We conducted a retrospective cohort study to compare the clinical presentations of acute IS in patients with and without NS. This study was a multi-institutional study and used data from Chang Gung Research Database of Taiwan from 1 January 2001, to 31 December 2017. A total of 233 IS patients with NS and 1358 IS patients without NS were enrolled. The median age of participants was 68 (range: 59-79) years. The risk of dependent functional status (modified Rankin Scale score≧3) after IS was higher in NS patients compared to those without NS (Odd ratio (OR) 4.02, 95% confidence interval (CI) 2.39 to 6.76, p < 0.001), particularly in stroke subtypes as small-artery occlusion (OR 8.02, 95% CI 3.94 to 16.32, p < 0.001), and stroke of undetermined etiology (OR 2.47, CI 1.06 to 5.76, p = 037). The risks of mortality or stroke recurrence within 30 days were similar between the two groups for all stroke subtypes. In conclusion, NS was associated with a higher risk of functional dependence following IS. Intensive treatment and rehabilitation should be considered for IS patients with NS. The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on the specific characteristics to stroke patients with NS. In this study, we aimed to examine the clinical manifestations of acute IS in a large group of NS patients, comparing to those without NS. We conducted a retrospective cohort study to compare the clinical presentations of acute IS in patients with and without NS. This study was a multi-institutional study and used data from Chang Gung Research Database of Taiwan from 1 January 2001, to 31 December 2017. A total of 233 IS patients with NS and 1358 IS patients without NS were enrolled. The median age of participants was 68 (range: 59–79) years. The risk of dependent functional status (modified Rankin Scale score≧3) after IS was higher in NS patients compared to those without NS (Odd ratio (OR) 4.02, 95% confidence interval (CI) 2.39 to 6.76, p < 0.001), particularly in stroke subtypes as small-artery occlusion (OR 8.02, 95% CI 3.94 to 16.32, p < 0.001), and stroke of undetermined etiology (OR 2.47, CI 1.06 to 5.76, p = 037). The risks of mortality or stroke recurrence within 30 days were similar between the two groups for all stroke subtypes. In conclusion, NS was associated with a higher risk of functional dependence following IS. Intensive treatment and rehabilitation should be considered for IS patients with NS. The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on the specific characteristics to stroke patients with NS. In this study, we aimed to examine the clinical manifestations of acute IS in a large group of NS patients, comparing to those without NS. We conducted a retrospective cohort study to compare the clinical presentations of acute IS in patients with and without NS. This study was a multi-institutional study and used data from Chang Gung Research Database of Taiwan from 1 January 2001, to 31 December 2017. A total of 233 IS patients with NS and 1358 IS patients without NS were enrolled. The median age of participants was 68 (range: 59-79) years. The risk of dependent functional status (modified Rankin Scale score≧3) after IS was higher in NS patients compared to those without NS (Odd ratio (OR) 4.02, 95% confidence interval (CI) 2.39 to 6.76, < 0.001), particularly in stroke subtypes as small-artery occlusion (OR 8.02, 95% CI 3.94 to 16.32, < 0.001), and stroke of undetermined etiology (OR 2.47, CI 1.06 to 5.76, = 037). The risks of mortality or stroke recurrence within 30 days were similar between the two groups for all stroke subtypes. In conclusion, NS was associated with a higher risk of functional dependence following IS. Intensive treatment and rehabilitation should be considered for IS patients with NS. |
Author | Chang, Chun-Wei Huang, Wen-Yi Chang, Chien-Hung Chang, Kuo-Hsuan Wu, Hsiu-Chuan Chen, Kuan-Hsing |
Author_xml | – sequence: 1 givenname: Wen-Yi surname: Huang fullname: Huang, Wen-Yi organization: Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Keelung branch, Taiwan – sequence: 2 givenname: Chun-Wei surname: Chang fullname: Chang, Chun-Wei organization: Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Linkou branch, Taiwan – sequence: 3 givenname: Kuan-Hsing surname: Chen fullname: Chen, Kuan-Hsing organization: Kidney Research Center, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taiwan – sequence: 4 givenname: Chien-Hung surname: Chang fullname: Chang, Chien-Hung organization: Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Linkou branch, Taiwan – sequence: 5 givenname: Hsiu-Chuan surname: Wu fullname: Wu, Hsiu-Chuan organization: Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Linkou branch, Taiwan – sequence: 6 givenname: Kuo-Hsuan surname: Chang fullname: Chang, Kuo-Hsuan organization: Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Linkou branch, Taiwan |
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Cites_doi | 10.1016/0140-6736(91)93206-o 10.4097/kjae.2013.64.5.402 10.1161/CIRCULATIONAHA.107.716951 10.1016/j.jstrokecerebrovasdis.2019.104322 10.1053/j.ackd.2010.10.003 10.1016/j.kint.2020.02.010 10.1161/01.str.31.5.1062 10.3346/jkms.2017.32.7.1072 10.1056/NEJMcibr1209459 10.1161/01.str.23.2.295 10.1016/S1052-3057(10)80031-X 10.1016/j.ensci.2015.10.002 10.1016/j.bj.2017.08.002 10.1053/j.ajkd.2012.11.051 10.1016/j.jstrokecerebrovasdis.2016.06.013 10.1161/01.str.24.1.35 10.1136/bmj.39576.709711.80 10.3345/kjp.2011.54.8.322 10.1590/2175-8239-JBN-2019-0001 10.1161/ATVBAHA.119.312705 10.1097/00041552-200403000-00004 10.1016/j.ekir.2017.04.004 10.3390/biomedicines10092094 10.1161/STROKEAHA.120.029680 10.1155/2015/382918 10.1016/j.hfc.2008.03.008 10.1002/pds.4713 10.4103/picr.PICR_123_17 10.1177/039463201302600322 10.1136/jnnp-2019-320526 10.3389/fcell.2020.00185 |
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Keywords | chronic kidney disease Nephrotic syndrome cerebral infarction stroke ischemic stroke |
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Snippet | The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on... |
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SubjectTerms | cerebral infarction chronic kidney disease Clinical Study Ischemia ischemic stroke Kidney diseases Nephrotic syndrome Patients Stroke |
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Title | Characteristics of acute ischemic stroke in patients with Nephrotic syndrome |
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