Does Chronic Kidney Disease Predict Stroke Risk Independent of Blood Pressure?: A Systematic Review and Meta-Regression

Stroke; a Journal of Cerebral Circulation
Dearbhla M Kelly, Peter M Rothwell

Abstract

Background and Purpose- Chronic kidney disease is strongly associated with stroke with various purported mechanisms proposed. Low glomerular filtration rate appears to be a risk factor for stroke independent of cardiovascular risk factors in epidemiological studies, but there has been no systematic assessment of the impact of more complete adjustment for blood pressure on the association. Methods- We did a systematic review to February 2018 (MEDLINE/EMBASE) for cohort studies or randomized controlled trials that reported stroke incidence in adults according to baseline estimated glomerular filtration rate. Study and participant characteristics and relative risks (RR) were extracted. Estimates were combined using a random-effects model. Heterogeneity was assessed by x2 statistics and I2 and by subgroup strata and meta-regression. Results- We identified 168 studies reporting data on 5 611 939 participants with 115 770 stroke outcomes. Eighty-five studies (3 417 098 participants; 72 996 strokes) provided adequate data for meta-analysis of estimated glomerular filtration rate and stroke risk. Incident stroke risk was increased among participants with estimated glomerular filtration rate <60 mL/min per 1.73 m2 (RR=1.73; 95% CI, 1.57...Continue Reading

References

Jan 15, 2020·International Journal of Stroke : Official Journal of the International Stroke Society·Dearbhla M Kelly, Peter M Rothwell
Aug 20, 2020·Stroke; a Journal of Cerebral Circulation·Dearbhla M KellyOxford Vascular Study
Jul 11, 2020·Journal of Hypertension·Rafael CarmenaJosep Redon

Citations

Nov 21, 2002·JAMA : the Journal of the American Medical Association·Jackson T WrightAfrican American Study of Kidney Disease and Hypertension Study Group
Jun 28, 2003·Stroke; a Journal of Cerebral Circulation·U G R Schulz, Peter M Rothwell
Apr 22, 2004·Journal of the American Society of Nephrology : JASN·Daniel E WeinerMark Sarnak
Aug 27, 2005·European Journal of Epidemiology·Yun-Mi SongYeong Sook Yun
Dec 17, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Toshiharu NinomiyaRachel Huxley
Feb 3, 2009·Stroke; a Journal of Cerebral Circulation·Gilad YahalomDavid Tanne
Dec 8, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Paul MuntnerChronic Renal Insufficiency Cohort (CRIC) Study Investigators
Mar 27, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Andrew Levey, Lesley A Stevens
Oct 5, 2010·BMJ : British Medical Journal·Meng LeeBruce Ovbiagele
May 18, 2012·Neurology·Y KumaiFSR Investigators
Aug 31, 2013·Stroke; a Journal of Cerebral Circulation·Bruce OvbiagelePRoFESS Investigators
Jul 18, 2014·Lancet Neurology·Kazunori Toyoda, Toshiharu Ninomiya
Feb 15, 2015·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Philip MassonJonathan C Craig
Nov 10, 2015·The New England Journal of Medicine·SPRINT Research GroupWalter T Ambrosius
Oct 17, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Youbao LiXianhui Qin
Oct 7, 2018·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Rakesh MalhotraSPRINT Research Group

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International Journal of Stroke : Official Journal of the International Stroke Society
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