دورية أكاديمية
أعرض في EDS

Estimated glomerular filtration rate predicts incident stroke among Ghanaians with diabetes and hypertension.

التفاصيل البيبلوغرافية
العنوان: Estimated glomerular filtration rate predicts incident stroke among Ghanaians with diabetes and hypertension.
المؤلفون: Sarfo FS; Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Electronic address: stephensarfo78@gmail.com., Mobula LM; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA., Sarfo-Kantanka O; Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Adamu S; Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Plange-Rhule J; Ghana College of Physicians and Surgeons, Accra, Ghana., Ansong D; Department of Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana., Gyamfi RA; Agogo Presbyterian Hospital, Agogo, Ghana., Duah J; Kings Medical Center, Botanga, Ghana., Abraham B; Atua Government Hospital, Somanya, Ghana., Ofori-Adjei D; Department of Medicine & Therapeutics, University of Ghana, School of Medicine and Dentistry, Accra, Ghana.
المصدر: Journal of the neurological sciences [J Neurol Sci] 2019 Jan 15; Vol. 396, pp. 140-147. Date of Electronic Publication: 2018 Nov 15.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0375403 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-5883 (Electronic) Linking ISSN: 0022510X NLM ISO Abbreviation: J Neurol Sci Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam : Elsevier, <19 ->
مواضيع طبية MeSH: Diabetes Mellitus, Type 2/*epidemiology , Glomerular Filtration Rate/*physiology , Hypertension/*epidemiology , Stroke/*epidemiology , Stroke/*physiopathology, Alcohol Drinking/epidemiology ; Cohort Studies ; Creatinine/blood ; Exercise/physiology ; Female ; Ghana/epidemiology ; Humans ; Hypertension/complications ; Incidence ; Lipid Metabolism ; Male ; Proportional Hazards Models ; Smoking/epidemiology
مستخلص: Background: Sub-Saharan Africa is currently experiencing a high burden of both chronic kidney disease (CKD) and stroke as a result of a rapid rise in shared common vascular risk factors such as hypertension and diabetes mellitus. However, no previous study has prospectively explored independent associations between CKD and incident stroke occurrence among indigenous Africans. This study sought to fill this knowledge gap.
Methods: A prospective cohort study involving Ghanaians adults with hypertension or type II diabetes mellitus from 5 public hospitals. Patients were followed every 2 months in clinic for 18 months and assessed clinically for first ever stroke by physicians. Serum creatinine derived estimated glomerular filtration rates (eGFR) were determined at baseline for 2631 (81.7%) out of 3296 participants. We assessed associations between eGFR and incident stroke using a multivariate Cox Proportional Hazards regression model.
Results: Stroke incidence rates (95% CI) increased with decreasing eGFR categories of 89, 60-88, 30-59 and <29 ml/min corresponding to incidence rates of 7.58 (3.58-13.51), 14.45 (9.07-21.92), 29.43 (15.95-50.04) and 66.23 (16.85-180.20)/1000 person-years respectively. Adjusted hazard ratios (95%CI) for stroke occurrence according to eGFR were 1.42 (0.63-3.21) for eGFR of 60-89 ml/min, 1.88 (1.17-3.02) for 30-59 ml/min and 1.52 (0.93-2.43) for <30 ml/min compared with eGFR of >89 ml/min. Adjusted HR for stroke occurrence among patients with hypertension with eGFR<60 ml/min was 3.69 (1.49-9.13), p = .0047 and among those with diabetes was 1.50 (0.56-3.98), p = .42.
Conclusion: CKD is dose-dependently associated with occurrence of incident strokes among Ghanaians with hypertension and diabetes mellitus. Further studies are warranted to explore interventions that could attenuate the risk of stroke attributable to renal disease among patients with hypertension in SSA.
(Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)
التعليقات: Comment in: J Neurol Sci. 2019 Feb 15;397:80. (PMID: 30594829)
Comment in: J Neurol Sci. 2019 Feb 15;397:112-113. (PMID: 30599300)
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فهرسة مساهمة: Keywords: APOL-1; Chronic kidney disease; Stroke risk; West Africa; eGFR
المشرفين على المادة: AYI8EX34EU (Creatinine)
تواريخ الأحداث: Date Created: 20181125 Date Completed: 20190722 Latest Revision: 20220408
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC6330840
DOI: 10.1016/j.jns.2018.11.017
PMID: 30471633
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-5883
DOI:10.1016/j.jns.2018.11.017