Diabetes: Stroke and Measure of Kidney Function, GFR

MedicalResearch.com Interview with:
Yongjun Wang, MD
Department of Neurology, Beijing Tiantan Hospital
Capital Medical University, Beijing, China

MedicalResearch.com: What are the main findings of the study?

Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively.

MedicalResearch.com: Were any of the findings unexpected?

Answer: Previous studies found that the association between eGFR and adverse outcomes appeared to be J-shaped, that is, reduce eGFR was associated with poor outcomes in many settings, while in our study we demonstrated that higher eGFR (≥ 120 ml/min/1.73m2) was also associated with increased risks of all-cause mortality and stroke recurrence.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: The clinical implications of our findings are important as it provides evidence that prevention and management of CKD is very important measure for type 2 diabetic patients with ischemic stroke or TIA, especially among those whose eGFR<45 ml/min/1.73m2 or ≥120 ml/min/1.73m2.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: There may be important racial and environmental differences that limit generalizability of our results and await results of future studies in association of higher eGFR with stroke outcomes in other ethnic groups.

Citation:

Association of glomerular filtration rate with outcomes of acute stroke in type 2 diabetic patients: results from the China National Stroke Registry.

Luo Y, Wang X, Wang Y, Wang C, Wang H, Wang D, Liu L, Jia Q, Liu G, Zhao X, Wang Y; on behalf of the CNSR investigators.

Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Diabetes Care. 2013 Sep 5. [Epub ahead of print]

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