title: Chronic kidney disease and stroke.
abstract: Chronic kidney disease (CKD) is associated with an increased risk of both ischemic and hemorrhagic stroke. In addition to shared risk factors, this higher cerebrovascular risk is mediated by several CKD-associated mechanisms including platelet dysfunction, coagulation disorders, endothelial dysfunction, inflammation, and increased risk of atrial fibrillation. CKD can also modify the effect of treatments used in acute stroke and in secondary stroke prevention. We review the epidemiology and pathophysiology that link CKD and stroke and the impact of CKD on stroke outcomes. Interdisciplinary collaboration between nephrologists, pharmacists, hematologists, nutrition therapists, primary care physicians, and neurologists in providing care to these subjects may potentially improve outcomes.
authors.affiliation: Department of Neurology, Duke University Medical Center, Durham, NC; and Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC. Electronic address: nelhusse@wakehealth.edu.
authors.forename: Nada
authors.initials: N
authors.lastname: El Husseini
authors.affiliation: Department of Neurology, Duke University Medical Center, Durham, NC; and Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC.
authors.forename: Omran
authors.initials: O
authors.lastname: Kaskar
authors.affiliation: Department of Neurology, Duke University Medical Center, Durham, NC; and Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, NC.
authors.forename: Larry B
authors.initials: LB
authors.lastname: Goldstein
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001791:Blood Platelet Disorders / Q000150:complications; D002545:Brain Ischemia / Q000209:etiology*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D020300:Intracranial Hemorrhages / Q000209:etiology*; D010348:Patient Care Team; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D017582:Renal Replacement Therapy / Q000009:adverse effects; D055502:Secondary Prevention; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D010959:Tissue Plasminogen Activator
keywords: Alteplase; Chronic kidney disease; Stroke; Stroke prevention; Thrombolysis