Wu Chia-Lin, Tsai Chun-Chieh, Kor Chew-Teng, Tarng Der-Cherng, Lian Ie-Bin, Yang Tao-Hsiang, Chiu Ping-Fang, Chang Chia-Chu
Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
School of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
PLoS One. 2016 Jun 29;11(6):e0158533. doi: 10.1371/journal.pone.0158533. eCollection 2016.
There is little information about the association between stroke and kidney diseases. We aimed to investigate the impact of stroke on long-term renal outcomes.
In this large population-based retrospective cohort study, we identified 100,353 subjects registered in the National Health Insurance Research Database of Taiwan from January 1, 2000, through December 31, 2012, including 33,451 stroke patients and 66,902 age-, sex- and Charlson's comorbidity index score-matched controls.
The incidence rate of chronic kidney disease (CKD) was higher in the stroke than in the control cohort (17.5 vs. 9.06 per 1000 person-years). After multivariate adjustment, the risk of developing CKD was significantly higher in patients with stroke (adjusted hazard ratio [aHR] 1.43, 95% confidence interval [CI] 1.36-1.50, P<0.001). Subgroup analysis showed that stroke patients <50 years (aHR 1.61, P<0.001) and those with concomitant diabetes mellitus (aHR 2.12, P<0.001), hyperlipidemia (aHR 1.53, P<0.001) or gout (aHR 1.84, P<0.001) were at higher risk of incident CKD. Additionally, the risks of progression to advanced CKD and end-stage renal disease (ESRD) were significantly higher for stroke patients (aHRs, 1.22 and 1.30; P = 0.04 and P = 0.008, respectively), independent of age, sex, comorbidities and long-term medications.
Stroke is associated with higher risks for incident CKD, decline in renal function and ESRD. Younger stroke patients, as well as those with concomitant diabetes mellitus, hyperlipidemia or gout are at greater risk for kidney diseases.
关于中风与肾脏疾病之间关联的信息较少。我们旨在研究中风对长期肾脏结局的影响。
在这项基于人群的大型回顾性队列研究中，我们确定了2000年1月1日至2012年12月31日在台湾国民健康保险研究数据库中登记的100353名受试者，包括33451名中风患者和66902名年龄、性别及查尔森合并症指数评分匹配的对照组。
中风队列中慢性肾脏病（CKD）的发病率高于对照组（每1000人年分别为17.5例和9.06例）。多变量调整后，中风患者发生CKD的风险显著更高（调整后风险比[aHR]1.43，95%置信区间[CI]1.36 - 1.50，P<0.001）。亚组分析显示，年龄<50岁的中风患者（aHR 1.61，P<0.001）以及合并糖尿病（aHR 2.12，P<0.001）、高脂血症（aHR 1.53，P<0.001）或痛风（aHR 1.84，P<0.001）的患者发生CKD的风险更高。此外，中风患者进展为晚期CKD和终末期肾病（ESRD）的风险显著更高（aHR分别为1.22和1.30；P分别为0.04和0.008），与年龄、性别、合并症和长期用药无关。
中风与发生CKD、肾功能下降及ESRD的较高风险相关。年轻的中风患者以及合并糖尿病、高脂血症或痛风的患者患肾脏疾病的风险更大。
