TY - JOUR
T1 - Incidence of stroke symptoms among adults with chronic kidney disease
T2 - Results from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study
AU - Muntner, Paul
AU - Judd, Suzanne E.
AU - McClellan, William
AU - Meschia, James F.
AU - Warnock, David G.
AU - Howard, Virginia J.
N1 - Funding Information:
Acknowledgements. Funding/support of sponsor. This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis or interpretation of the data.
PY - 2012/1
Y1 - 2012/1
N2 - Background.Reduced glomerular filtration rate and albuminuria are associated with an increased risk for stroke. Their association with stroke symptoms is not known. Methods.The incidence of stroke symptoms was determined in 20386 participants ≥45 years of age in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of a history of stroke, transient ischemic attack and stroke symptoms at baseline. Six stroke symptoms were assessed via telephone interviews at baseline and every 6 months. Participants were followed over a median of 2.1 years (maximum follow-up of 6 years). Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation and the albumin-to-creatinine ratio from spot urine samples. Results.The incidence of any stroke symptom (n = 2548 cases) was 10.8, 12.9, 18.2 and 20.7% among participants with an eGFR ≥90, 60-89, 45-59 and <45 mL/min/1.73m 2, respectively, and 10.8, 14.4, 17.0 and 18.8 for participants with albumin-to-creatinine ratios <10, 10-29, 30-299 and ≥300 mg/g, respectively (each P-trend < 0.001). The multivariable-adjusted hazard ratio (95% confidence interval) for any stroke symptom was 1.02 (0.91-1.14), 1.22 (1.01-1.48) and 1.26 (0.98-1.62) for those with an eGFR of 60-89, 45-59 and <45 mL/min/1.73m 2, respectively, versus ≥90 mL/min/1.73m 2 (P-trend = 0.022) and 1.16 (1.03-1.31), 1.29 (1.12-1.50) and 1.11 (0.82-1.49) for those with albumin-to-creatinine ratios of 10-29, 30-299 and ≥300 versus <10 mg/g, respectively (P-trend = 0.005). Conclusions.Reduced eGFR and higher albuminuria levels are associated with an increased risk for incident stroke symptoms.
AB - Background.Reduced glomerular filtration rate and albuminuria are associated with an increased risk for stroke. Their association with stroke symptoms is not known. Methods.The incidence of stroke symptoms was determined in 20386 participants ≥45 years of age in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of a history of stroke, transient ischemic attack and stroke symptoms at baseline. Six stroke symptoms were assessed via telephone interviews at baseline and every 6 months. Participants were followed over a median of 2.1 years (maximum follow-up of 6 years). Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation and the albumin-to-creatinine ratio from spot urine samples. Results.The incidence of any stroke symptom (n = 2548 cases) was 10.8, 12.9, 18.2 and 20.7% among participants with an eGFR ≥90, 60-89, 45-59 and <45 mL/min/1.73m 2, respectively, and 10.8, 14.4, 17.0 and 18.8 for participants with albumin-to-creatinine ratios <10, 10-29, 30-299 and ≥300 mg/g, respectively (each P-trend < 0.001). The multivariable-adjusted hazard ratio (95% confidence interval) for any stroke symptom was 1.02 (0.91-1.14), 1.22 (1.01-1.48) and 1.26 (0.98-1.62) for those with an eGFR of 60-89, 45-59 and <45 mL/min/1.73m 2, respectively, versus ≥90 mL/min/1.73m 2 (P-trend = 0.022) and 1.16 (1.03-1.31), 1.29 (1.12-1.50) and 1.11 (0.82-1.49) for those with albumin-to-creatinine ratios of 10-29, 30-299 and ≥300 versus <10 mg/g, respectively (P-trend = 0.005). Conclusions.Reduced eGFR and higher albuminuria levels are associated with an increased risk for incident stroke symptoms.
KW - albuminuria
KW - chronic kidney disease
KW - stroke
KW - stroke symptoms
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U2 - 10.1093/ndt/gfr218
DO - 10.1093/ndt/gfr218
M3 - Article
C2 - 21551093
AN - SCOPUS:84856685329
SN - 0931-0509
VL - 27
SP - 166
EP - 173
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 1
ER -