Reduced Glomerular Filtration Rate and Risk of Stroke: A Nationwide Cohort Study in South Korea
- 주제(키워드) Chronic renal insufficiency , Glomerular filtration rate , Stroke , Cerebral hemorrhage , Cerebral infarction
- 주제(기타) Peripheral Vascular Disease
- 설명문(일반) [Oh, Chang-Mo; Choi, Joong-Myung] Kyung Hee Univ, Sch Med, Dept Prevent Med, Seoul, South Korea; [Park, Sung Keun; Jung, Ju Young] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Total Healthcare Ctr, Sch Med, Seoul, South Korea; [Ha, Eunhee] Ewha Womans Univ, Coll Med, Dept Occupat & Environm Med, 1 Hoegi Dong, Seoul 130701, South Korea; [Lee, Eun-Young] Kyung Hee Univ, Grad Sch, Dept Biomed Sci, Seoul, South Korea; [Kim, Jung-Wook] Kyung Hee Univ, Sch Med, Dept Internal Med, Div Gastroenterol & Hepatol, Seoul, South Korea; [Kang, Hee Yong] Kyung Hee Univ, Dept Anesthesiol & Pain Med, Seoul, South Korea; [Yang, Hong Jun] Kyung Hee Univ, Grad Sch, Dept Prevent Med, Seoul, South Korea; [Ryoo, Jae-Hong] Kyung Hee Univ, Sch Med, Dept Occupat & Environm Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 JAPAN ATHEROSCLEROSIS SOC
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000183516
- 본문언어 영어
- Published As http://dx.doi.org/10.5551/jat.56143
초록/요약
Aims: Although chronic kidney disease is recognized as an independent risk factor for cerebrovascular disease, its association with hemorrhagic and ischemic stroke remains controversial. Methods: We conducted a retrospective cohort study using the National Health Insurance Service-National Sample Cohort, which is representative of the Korean population. A total of 195,772 Koreans who were not diagnosed with stroke before 2009 were included in this study from 2009 to 2013. The eGFR was divided into six categories (>= 90, 75-89, 60-74, 45-59, 30-44, <30 mL/min/1.73 m(2)). The Kaplan-Meier plot was illustrated to compare the incidence of stroke. Cox proportional hazard model was used to estimate the hazard ratio (HR) of eGFR for risk of ischemic and hemorrhagic stroke by sex. Results: During an average of 4.36 years of follow-up period, 2,236 and 668 people were diagnosed with newly ischemic and hemorrhagic stroke, respectively. Age-adjusted incidence rate for ischemic stroke among people with eGFR < 45 mL/min/1.73 m(2) was higher than those with eGFR >= 90 mL/min/1.73 m(2), whereas that for hemorrhagic stroke among people with eGFR >= 90 mL/min/1.73 m(2) was higher than those with eGFR < 45 mL/min/1.73 m(2). After adjusting for multiple covariates, the adjusted HR for ischemic stroke increased with decreasing eGFR in men (p for trend <0.001), but not in women (p for trend = 0.48). On the other hand, there was no significant relationship between eGFR and risk of hemorrhagic stroke in both men and women. Conclusions: Reduced glomerular filtration rate less than 45 mL/min/1.73 m(2) was associated with an increased risk of ischemic stroke, especially in men.
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