CNS neuroscience & therapeutics · 2026
Association Between Differences in Estimated GFR by Creatinine Vs. Cystatin C and Stroke Outcomes: Results From the Third China National Stroke Registry.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Huang Qi, Pan Yuesong, Yan Hongyi, Meng Xia, Zhang Yin, Wang Mengxing, Wang Anxin, Zhou Yilun, Wang Yongjun
Аннотация
BACKGROUND: The effect of the difference between cystatin C- and creatinine-based estimated glomerular filtration rates (eGFRdiff) on stroke outcomes is unclear. This study investigated the association between eGFRdiff and stroke prognosis.
METHODS: Participants with ischaemic stroke or transient ischaemic attack were recruited from the Third China National Stroke Registry, a multicenter, prospective cohort. eGFRdiff was calculated using the absolute difference (eGFRabdiff defined as cystatin C-based (eGFRcys) minus creatinine-based (eGFRcr)) and the ratio (eGFRrediff) between eGFRcys and eGFRcr estimates. eGFRabdiff (< -15, -15-15, ≥ 15 mL/min/1.73 m2) and eGFRrediff (< 0.6, ≥ 0.6) were analyzed. Time-updated eGFRdiff (ΔeGFRdiff) was defined as the change from baseline to 1-year blood re-examination and tertiled. Outcomes included 5-year all-cause mortality, stroke disability, and stroke recurrence.
RESULTS: Among 10,293 participants, 35.2% had an eGFRabdiff < -15 mL/min/1.73 m2, and 3.5% had an eGFRrediff < 0.6. Compared with midrange eGFRabdiff, participants with eGFRabdiff < -15 mL/min/1.73 m2 had an odds ratio (OR) of 1.19 (95% confidence interval (CI), 1.05-1.35) for disability and a hazard ratio (HR) of 1.28 (95% CI, 1.12-1.46) for mortality. eGFRrediff < 0.6 was associated with a higher risk for disability (OR, 1.66; 95% CI, 1.25-2.19) and mortality (HR, 1.49; 95% CI, 1.17-1.90). Participants with the largest ΔeGFRdiff declines had higher mortality (OR, 1.44; 95% CI, 1.14-1.82) and borderline disability risk significance (HR, 1.25; 95% CI, 0.96-1.61).
CONCLUSIONS: Significant and widening eGFRdiff were independently associated with increased risks of post-stroke disability and mortality, highlighting the importance of monitoring eGFRcys and eGFRcr in stroke management.
METHODS: Participants with ischaemic stroke or transient ischaemic attack were recruited from the Third China National Stroke Registry, a multicenter, prospective cohort. eGFRdiff was calculated using the absolute difference (eGFRabdiff defined as cystatin C-based (eGFRcys) minus creatinine-based (eGFRcr)) and the ratio (eGFRrediff) between eGFRcys and eGFRcr estimates. eGFRabdiff (< -15, -15-15, ≥ 15 mL/min/1.73 m2) and eGFRrediff (< 0.6, ≥ 0.6) were analyzed. Time-updated eGFRdiff (ΔeGFRdiff) was defined as the change from baseline to 1-year blood re-examination and tertiled. Outcomes included 5-year all-cause mortality, stroke disability, and stroke recurrence.
RESULTS: Among 10,293 participants, 35.2% had an eGFRabdiff < -15 mL/min/1.73 m2, and 3.5% had an eGFRrediff < 0.6. Compared with midrange eGFRabdiff, participants with eGFRabdiff < -15 mL/min/1.73 m2 had an odds ratio (OR) of 1.19 (95% confidence interval (CI), 1.05-1.35) for disability and a hazard ratio (HR) of 1.28 (95% CI, 1.12-1.46) for mortality. eGFRrediff < 0.6 was associated with a higher risk for disability (OR, 1.66; 95% CI, 1.25-2.19) and mortality (HR, 1.49; 95% CI, 1.17-1.90). Participants with the largest ΔeGFRdiff declines had higher mortality (OR, 1.44; 95% CI, 1.14-1.82) and borderline disability risk significance (HR, 1.25; 95% CI, 0.96-1.61).
CONCLUSIONS: Significant and widening eGFRdiff were independently associated with increased risks of post-stroke disability and mortality, highlighting the importance of monitoring eGFRcys and eGFRcr in stroke management.