title: Association between renal dysfunction and 3-year mortality in patients with acute first-ever ischemic stroke.
abstract: OBJECTIVE
  The influence of renal dysfunction on the clinical presentation and outcomes of patients with acute ischemic stroke is still controversial. We investigate the influence of renal dysfunction on the outcomes of patients with acute first-ever ischemic stroke.
  
  
  METHODS
  Nine-hundred thirty-four patients with acute first-ever ischemic stroke were enrolled and followed for 3 years. Renal function was assessed using the equation of the Modification Diet for Renal Disease for estimated glomerular filtration rate (eGFR). Serum creatinine levels were obtained within 3 days of acute stroke onset. Reduced eGFR was defined as eGFR<60ml/min/1.73m(2). Clinical presentation, risk factors for stroke, laboratory data, co-morbidities, and outcomes were recorded.
  
  
  RESULTS
  Total 264 patients (28.3%) had a reduced eGFR. The prevalence of older age, hypertension, and atrial fibrillation was significantly higher in patients with a reduced eGFR. Total anterior circulation syndrome occurred more frequently among patients with a reduced eGFR (P=0.010). Multivariate Cox regression revealed that a reduced eGFR is a significant predictor of 3-year mortality (HR=1.67, 95% CI=1.06-2.62, P=0.026).
  
  
  CONCLUSIONS
  Reduced eGFR during the acute stroke stage is associated with increased risk of 3-year mortality. Furthermore, risk of acute complications and poor functional outcomes following discharge was significantly higher in patients with a reduced eGFR.
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Shun-Wen
authors.initials: SW
authors.lastname: Lin
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Weng
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Huang
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Feng-Chieh
authors.initials: FC
authors.lastname: Su
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Tsung-I
authors.initials: TI
authors.lastname: Peng
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Yu-Yi
authors.initials: YY
authors.lastname: Chien
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Chia-Lun
authors.initials: CL
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Kuang-Yung
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Yi-Jing
authors.initials: YJ
authors.lastname: Yu
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan.
authors.forename: Jun-Xue
authors.initials: JX
authors.lastname: Zhu
authors.affiliation: Department of Neurology, Chang-Gung Memorial Hospital, Keelung Branch, No. 222, Mai-Jin Road, Keelung Zip. 204, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan Zip. 333, Taiwan. Electronic address: wenyihuang2003@yahoo.com.tw.
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality; D002545:Brain Ischemia / Q000150:complications*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000401:mortality*; D013997:Time Factors
keywords: Chronic kidney disease; First-ever ischemic stroke; Mortality; Recurrent stroke; Renal dysfunction; Stroke outcome