Mori Takahisa, Yano Tetsundo, Yoshioka Kazuhiro, Miyazaki Yuichi
Department of Stroke Treatment, Shonan Kamakura General Hospital, Kamakura City 247-8533, Japan.
J Cardiovasc Dev Dis. 2023 Sep 19;10(9):405. doi: 10.3390/jcdd10090405.
Severe renal dysfunction (SRD), an advanced stage of chronic kidney disease (CKD), can limit the treatment options for acute stroke (AS) patients. Therefore, it is important to investigate the associated factors of SRD in AS patients to inhibit CKD progression to SRD before AS. Sex differences exist in the renal function. Therefore, we investigated the frequency of SRD and its associated factors among AS patients by sex.
Our cross-sectional study included patients admitted within 24 h of AS onset between 2013 and 2019 with available pre-stroke medication information. We used the Cockcroft-Gault equation for calculating the creatinine clearance (Ccr) and defined SRD as a Ccr < 30 mL/min. We performed multivariable logistic regression analysis to identify the independent factors associated with SRD.
Out of 4294 patients, 3472 matched our criteria. Of these, 1905 (54.9%) were male, with median ages of 75 and 81 years for males and females, respectively. The frequency of SRD was 9.7% in males and 18.7% in females. Loop diuretics and anemia were associated factors of SRD.
Pre-stroke loop diuretics and anemia in elderly patients were associated factors of SRD in both sexes. Individualized drug therapy and anemia management are essential to prevent SRD.
严重肾功能不全（SRD）是慢性肾脏病（CKD）的晚期阶段，会限制急性卒中（AS）患者的治疗选择。因此，研究AS患者中SRD的相关因素，以在AS发生前抑制CKD进展为SRD很重要。肾功能存在性别差异。因此，我们按性别调查了AS患者中SRD的发生率及其相关因素。
我们的横断面研究纳入了2013年至2019年间AS发病24小时内入院且有卒中前用药信息的患者。我们使用Cockcroft-Gault方程计算肌酐清除率（Ccr），并将SRD定义为Ccr < 30 mL/分钟。我们进行多变量逻辑回归分析以确定与SRD相关的独立因素。
4294例患者中，3472例符合我们的标准。其中，1905例（54.9%）为男性，男性和女性的中位年龄分别为75岁和81岁。男性SRD的发生率为9.7%，女性为18.7%。袢利尿剂和贫血是SRD的相关因素。
老年患者卒中前使用袢利尿剂和贫血是两性SRD的相关因素。个体化药物治疗和贫血管理对于预防SRD至关重要。
