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Comparison of Associations of Outcomes After Stroke With Estimated GFR Using Chinese Modifications of the MDRD Study and CKD-EPI Creatinine Equations: Results From the China National Stroke Registry
Background: The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation estimates glomerular filtration rate (GFR) more precisely than the MDRD (Modification of Diet in Renal Disease) Study equation. The risk implications of this equation have been compared with the MDRD Study equation in different demographic and clinical characteristics. However, whether a Chinese modification of this equation performs better than a Chinese modification of the MDRD Study equation in risk prediction in Chinese patients with stroke is unknown.Study Design: Prospective cohort study, China National Stroke Registry.Set...
Source: American Journal of Kidney Diseases - October 7, 2013 Category: Urology & Nephrology Authors: Xianwei Wang, Yang Luo, Yilong Wang, Chunxue Wang, Xingquan Zhao, David Wang, Liping Liu, Gaifen Liu, Yongjun Wang, China National Stroke Registry Investigators Tags: Pathogenesis and Treatment of Kidney Disease Source Type: research

Risk of Stroke in Long-term Dialysis Patients Compared With the General Population
Conclusions: Patients undergoing dialysis are at elevated risk of stroke. Patients undergoing PD appear to be less likely to develop hemorrhagic stroke than those undergoing HD. Comprehensive control of hypertension and diabetes is necessary when delivering dialysis treatment.
Source: American Journal of Kidney Diseases - December 2, 2013 Category: Urology & Nephrology Authors: Hsi-Hao Wang, Shih-Yuan Hung, Junne-Ming Sung, Kuan-Yu Hung, Jung-Der Wang Tags: Dialysis Source Type: research

Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report
Publication date: Available online 21 September 2017 Source:American Journal of Kidney Diseases Author(s): Vinod K. Bansal, Charles A. Herzog, Mark J. Sarnak, Michael J. Choi, Ravindra Mehta, Bernard G. Jaar, Michael V. Rocco, Holly Kramer Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as...
Source: American Journal of Kidney Diseases - September 21, 2017 Category: Urology & Nephrology Source Type: research

Impact and Interaction of Low Estimated GFR and B Vitamin Therapy on Prognosis Among Ischemic Stroke Patients: The Vitamin Intervention for Stroke Prevention (VISP) Trial
The objective of this study was to conduct a secondary analysis based on the Vitamin Intervention for Stroke Prevention (VISP) trial to clarify these issues. Study Design: In the VISP trial, patients with a prior ischemic stroke were randomly assigned to receive the high- or low-dose B vitamin therapy. The trial did not find a difference between randomly assigned groups. The present study is a secondary analysis of the VISP trial. Setting & Participants: We analyzed the database of a multicenter trial comprising 3,673 patients with recent ischemic stroke who were followed up for 2 years. Predictor: We subdivided the ...
Source: American Journal of Kidney Diseases - April 8, 2013 Category: Urology & Nephrology Authors: Meng Lee, Daniela Markovic, Bruce Ovbiagele Tags: Pathogenesis and Treatment of Kidney Disease Source Type: research

ESRD After Heart Failure, Myocardial Infarction, or Stroke in Type  2 Diabetic Patients With CKD
Conclusions Most ESRD cases occurred in individuals without intercurrent CV events who had lower eGFRs than individuals with intercurrent CV events, but similar post-ESRD mortality. Nevertheless, intercurrent CV events, particularly heart failure, are strongly associated with risk for ESRD. These findings underscore the need for kidney-specific therapies in addition to treatment of CV risk factors to lower ESRD incidence in diabetes.
Source: American Journal of Kidney Diseases - June 7, 2017 Category: Urology & Nephrology Source Type: research

Geographic Variation in CKD Prevalence and ESRD Incidence in the United States: Results From the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Background: It is not known whether geographic differences in the prevalence of chronic kidney disease exist and are associated with end-stage renal disease (ESRD) incidence rates across the United States. Study Design: Cross-sectional and ecologic. Setting & Participants: White (n = 16,410) and black (n = 11,109) participants from across the continental United States in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Predictor: Geographic region, defined by the 18 networks of the US ESRD Network Program. Outcomes & Measurements: Albuminuria, defined as albumin-creatin...
Source: American Journal of Kidney Diseases - December 10, 2012 Category: Urology & Nephrology Authors: Rikki M. Tanner, Orlando M. Gutiérrez, Suzanne Judd, William McClellan, C. Barrett Bowling, Brian D. Bradbury, Monika M. Safford, Mary Cushman, David Warnock, Paul Muntner Tags: Pathogenesis and Treatment of Kidney Disease Source Type: research

Incident ESRD and Treatment-Resistant Hypertension: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Conclusions: Individuals with treatment-resistant hypertension are at increased risk for ESRD. Appropriate clinical management strategies are needed to treat treatment-resistant hypertension in order to preserve kidney function in this high-risk group.
Source: American Journal of Kidney Diseases - January 2, 2014 Category: Urology & Nephrology Authors: Rikki M. Tanner, David A. Calhoun, Emmy K. Bell, C. Barrett Bowling, Orlando M. Gutiérrez, Marguerite R. Irvin, Daniel T. Lackland, Suzanne Oparil, William McClellan, David G. Warnock, Paul Muntner Tags: Pathogenesis and Treatment of Kidney Disease Source Type: research

Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study
Conclusions In this cohort of older adults, obesity as measured by waist circumference is associated with higher ESRD risk even with adjustment for BMI, whereas obesity as measured by BMI is not associated with higher ESRD risk after adjustment for waist circumference. However, no significant association is noted between increased waist circumference and ESRD risk after adjustment for obesity-related comorbid conditions, eGFR, and ACR.
Source: American Journal of Kidney Diseases - July 17, 2015 Category: Urology & Nephrology Source Type: research

Measures of Kidney Disease and the Risk of Venous Thromboembolism in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study
Conclusions There was an independent association of low eGFR (<45 vs ≥90mL/min/1.73m2) with VTE risk, but no association of ACR and VTE.
Source: American Journal of Kidney Diseases - January 23, 2017 Category: Urology & Nephrology Source Type: research

Outcomes After Warfarin Initiation in a Cohort of Hemodialysis Patients With Newly Diagnosed Atrial Fibrillation
Conclusions In hemodialysis patients with incident AF, warfarin use was marginally associated with reduced risk of ischemic stroke, and there was a signal toward reduced mortality in as-treated analyses. These results support clinical equipoise regarding the use of warfarin in hemodialysis patients and underscore the need for randomized trials to fill this evidence gap.
Source: American Journal of Kidney Diseases - July 9, 2015 Category: Urology & Nephrology Source Type: research

Treatment of Anemia With Darbepoetin Prior to Dialysis Initiation and Clinical Outcomes: Analyses From the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT)
ConclusionsDespite initiating dialysis therapy with a higher hemoglobin level, prior treatment with darbepoetin was not associated with a reduction in mortality, myocardial infarction, or heart failure in the first 180 days, but a higher frequency of stroke was observed. In the absence of more definitive data, this may inform decisions regarding the use of erythropoiesis-stimulating agents to treat mild to moderate anemia in patients with type 2 diabetes and chronic kidney disease nearing dialysis therapy initiation.
Source: American Journal of Kidney Diseases - December 19, 2018 Category: Urology & Nephrology Source Type: research

Anatomic Brain Disease in Hemodialysis Patients: A Cross-sectional Study
Background: Although dialysis patients are at high risk of stroke and have a high burden of cognitive impairment, there are few reports of anatomic brain findings in the hemodialysis population. Using magnetic resonance imaging of the brain, we compared the prevalence of brain abnormalities in hemodialysis patients with that in a control population without known kidney disease. Study Design: Cross-sectional cohort. Setting & Participants: 45 maintenance hemodialysis patients and 67 controls without reported kidney disease, both without history of known stroke. Predictor: The primary predictor was dialysis status. Co...
Source: American Journal of Kidney Diseases - October 5, 2012 Category: Urology & Nephrology Authors: David A. Drew, Rafeeque Bhadelia, Hocine Tighiouart, Vera Novak, Tammy M. Scott, Kristina V. Lou, Kamran Shaffi, Daniel E. Weiner, Mark J. Sarnak Tags: Dialysis Source Type: research

Atrial Fibrillation in CKD: Balancing the Risks and Benefits of Anticoagulation
Chronic kidney disease (CKD) and atrial fibrillation are common conditions that often coexist and are associated with increased risk of stroke. Despite the wealth of evidence for optimal management of atrial fibrillation in the general population, the role of anticoagulation with warfarin in individuals with CKD with atrial fibrillation is far less well defined. Current recommendations for anticoagulation in patients treated with dialysis and those with an earlier stage of CKD are based on clinical trials in the general atrial fibrillation population that have largely excluded individuals with CKD. Observational studies of...
Source: American Journal of Kidney Diseases - June 7, 2013 Category: Urology & Nephrology Authors: Khai P. Ng, Nicola C. Edwards, Gregory Y.H. Lip, Jonathan N. Townend, Charles J. Ferro Tags: In Practice Source Type: research

Acute Kidney Injury and Prognosis After Cardiopulmonary Bypass: A Meta-analysis of Cohort Studies
Conclusions CPB-associated AKI is associated with a more than 2-fold increase in early mortality regardless of AKI definition.
Source: American Journal of Kidney Diseases - November 16, 2014 Category: Urology & Nephrology Source Type: research

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