Association between white matter lesions, renal dysfunction and functional outcome in ischemic stroke patients

Viac o knihe

Background and Purpose: White matter lesions (WMLs) are prevalent in patients with renal dysfunction and linked to functional outcomes after stroke. This study aimed to assess whether WMLs and decreased estimated glomerular filtration rate (eGFR) predict stroke functional outcomes at one year. Methods: A retrospective analysis was conducted using data from the Berlin “Cream& Sugar” cohort study (NCT 01378468) from Jan. 2009 to Mar. 2012. Patients aged over 18 with first-ever acute ischemic stroke, complete follow-up, eGFR, and MRI data were included. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS). Serum creatinine was measured 3-7 days post-stroke, and eGFR was calculated using the MDRD formula. WML severity was assessed via FLAIR or T2-weighted sequences using Fazekas scales. Functional outcomes were evaluated through telephone interviews at one year using the modified Rankin Scale (mRS). Age, gender, NIHSS, eGFR, and WMLs were analyzed using binary logistic regression. Results: The study included 160 patients (median age 66 years, 63.1% male, median NIHSS 2). eGFR < 90 mL/min/1.73m² was linked to WMLs (OR 2.30, p = 0.014). Binary logistic regression indicated that eGFR 30-60 mL/min/1.73m² (OR 7.86, p = 0.007), moderate-to-severe WMLs (OR 2.22, p = 0.042), and NIHSS ≥ 5 (OR 6.77, p = 0.002) were independently associated with unfavorable outcomes (mRS ≥ 2) at one year. Conclusion: Re