Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Nephrol Dial Transplant. 2012 Jan;27(1):166-73. doi: 10.1093/ndt/gfr218. Epub 2011 May 5.
Reduced glomerular filtration rate and albuminuria are associated with an increased risk for stroke. Their association with stroke symptoms is not known.
The incidence of stroke symptoms was determined in 20 386 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.
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).
Reduced eGFR and higher albuminuria levels are associated with an increased risk for incident stroke symptoms.
肾小球滤过率降低和白蛋白尿与中风风险增加有关。但其与中风症状的关系尚不清楚。
在无中风、短暂性脑缺血发作和中风症状史的 20386 名年龄≥45 岁的 REasons for Geographic and Racial Differences in Stroke（REGARDS）研究参与者中，确定中风症状的发生率。通过基线和每 6 个月一次的电话访谈评估 6 种中风症状。参与者中位随访时间为 2.1 年（最长随访时间为 6 年）。使用 CKD-EPI 方程和即时尿样的白蛋白/肌酐比值计算估计肾小球滤过率（eGFR）。
任何中风症状（n=2548 例）的发生率分别为 eGFR≥90、60-89、45-59 和<45 mL/min/1.73m2 的参与者为 10.8%、12.9%、18.2%和 20.7%，白蛋白/肌酐比值<10、10-29、30-299 和≥300 mg/g 的参与者分别为 10.8%、14.4%、17.0%和 18.8%（每个 P 趋势<0.001）。与 eGFR≥90 mL/min/1.73m2 相比，eGFR 为 60-89、45-59 和<45 mL/min/1.73m2 的参与者发生任何中风症状的多变量调整后的风险比（95%置信区间）分别为 1.02（0.91-1.14）、1.22（1.01-1.48）和 1.26（0.98-1.62）（P 趋势=0.022）；白蛋白/肌酐比值为 10-29、30-299 和≥300 与<10 mg/g 相比，参与者发生任何中风症状的风险比分别为 1.16（1.03-1.31）、1.29（1.12-1.50）和 1.11（0.82-1.49）（P 趋势=0.005）。
肾小球滤过率降低和白蛋白尿水平升高与中风症状的发生风险增加相关。
