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      Stroke and cerebrovascular diseases in patients with chronic kidney disease.

      1 , 2

      The Lancet. Neurology

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          Abstract

          Chronic kidney disease, defined as a reduced glomerular filtration rate or increased urinary albumin excretion, is recognised as a rapidly growing global health burden, and increasing evidence suggests that it contributes to the risk and severity of cerebrovascular diseases. In particular, chronic kidney disease is an established risk factor for stroke and is also strongly associated with subclinical cerebrovascular abnormalities and cognitive impairment, partly because it shares several traditional and non-traditional risk factors, and sometimes uraemia-related and dialysis-related factors, with cerebrovascular diseases. The effect of chronic kidney disease on incident stroke differs among regions and races and is greater in Asian than in non-Asian people. Chronic kidney disease seems to be predictive of severe neurological deficits and poor vital and functional outcomes after both ischaemic and haemorrhagic strokes, which is partly due to the limitations of pharmacotherapies, including limited use and effects of novel oral anticoagulants, other antithrombotic treatments, and reperfusion treatment for hyperacute ischaemic stroke. In view of the strong two-way association between stroke and kidney disease, the pathophysiological interactions between the brain and kidney should be the subject of intensive study.

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          Author and article information

          Journal
          Lancet Neurol
          The Lancet. Neurology
          1474-4465
          1474-4422
          Aug 2014
          : 13
          : 8
          Affiliations
          [1 ] Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. Electronic address: toyoda@ncvc.go.jp.
          [2 ] Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
          Article
          S1474-4422(14)70026-2
          10.1016/S1474-4422(14)70026-2
          25030514
          Copyright © 2014 Elsevier Ltd. All rights reserved.

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