title: Proteinuria independently predicts unfavorable outcome of ischemic stroke patients receiving intravenous thrombolysis.
abstract: OBJECTIVE
  Patients with low estimated glomerular filtration rate (eGFR) and proteinuria may be at increased risk for stroke. This study investigated whether low eGFR and proteinuria are outcome predictors in stroke patients treated with intravenous thrombolysis.
  
  
  METHODS
  We studied 432 consecutive stroke patients who received thrombolysis from January 2006 to December 2012, in Taiwan. Unfavorable outcome was defined as modified Rankin scale ≥2 at 3 months after stroke. Proteinuria was classified as negative or trace, mild, and moderate to severe. Using logistic regression analysis, we identified independent factors for unfavorable outcome after thrombolysis.
  
  
  RESULTS
  Of all patients, 32.7% had proteinuria. Patients with proteinuria were older, had higher frequencies of diabetes mellitus, hyperlipidemia, atrial fibrillation, lower eGFR, and greater severity of stroke upon admission than those without proteinuria. Proteinuria, not low eGFR, was an independent predictor for unfavorable outcome for stroke (OR = 2.00 for mild proteinuria, p = 0.035; OR = 2.54 for moderate to severe proteinuria, p = 0.035). However, no clear relationship was found between proteinuria and symptomatic hemorrhage after thrombolysis.
  
  
  CONCLUSIONS
  Proteinuria is an independent predictor of unfavorable outcome for acute ischemic stroke in patients treated with intravenous thrombolysis, indicating the crucial role of chronic kidney disease on the effectiveness of thrombolysis.
authors.affiliation: Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan ; Division of Neurology, Department of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Chen
authors.forename: Sung-Chun
authors.initials: SC
authors.lastname: Tang
authors.forename: Li-Kai
authors.initials: LK
authors.lastname: Tsai
authors.forename: Shin-Joe
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Kai-Hsiang
authors.initials: KH
authors.lastname: Chen
authors.forename: Chen-Hua
authors.initials: CH
authors.lastname: Li
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Hsiao
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Bak-Sau
authors.initials: BS
authors.lastname: Yip
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000503:physiopathology*; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy