Patients with renal impairment more likely to suffer from cardioembolic stroke later

To resolve this controversy, the researchers analyzed clinical data from over 10,000 individuals from the Japan Stroke Data Bank, a nationwide database of patients with acute stroke. This multicenter hospital-based registry has the advantages of including standardized clinical information, ensuring a valid diagnosis of stroke, and involving acute management by stroke specialists.

"Using such a large and comprehensive database enabled us to definitively show that low filtration rates and high levels of protein in the urine are associated with cardioembolic stroke, while small vessel occlusion was less common compared to other types of stroke," states Masatoshi Koga, second author on the paper.

In addition to the increased risk of cardioembolic stroke, low filtration rate predicted a disability after cardioembolic stroke, and both low filtration rate and high urine protein levels were linked to a greater chance of dying during hospitalization for stroke.

"Our findings conclusively show that there is a statistically significant association between renal impairment and clinical outcomes after specific ischemic stroke subtypes," states Kazunori Toyoda, senior author on the paper.

Given that almost 10% of the worldwide population suffers from chronic kidney disease, the insights provided by this large-scale study could help predict the risk of stroke and the ultimate prognosis in many of these patients. Understanding what subtype of stroke patients with impaired kidney function are likely to undergo may be useful for guiding preventive treatment.