Document Detail


New insights into stroke in chronic kidney disease.
MedLine Citation:
PMID:  18805379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with chronic kidney disease (CKD) are predisposed to stroke, especially as the estimated glomerular filtration rate decreases. This update reviews the pathologic mechanisms particular to this stroke population. The treatment for primary and secondary prevention of stroke is reviewed with respect to antiplatelet agents, anticoagulants, surgery, and carotid stenting. The control of chronic hypertension is particularly important in reducing stroke risk in CKD. In patients with prior stroke from atherosclerosis, antiplatelet agents are most beneficial in reducing secondary stroke risk. Those with atrial fibrillation and CKD may benefit from warfarin anticoagulation. Statins in CKD for stroke reduction in diabetics receiving dialysis are not useful, and the data are pending for their use in stroke reduction in the general CKD population. In carefully selected cases, carotid endarterectomy can be a treatment. The data on carotid stenting are conflicting.
Authors:
Sami L Khella
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Advances in chronic kidney disease     Volume:  15     ISSN:  1548-5609     ISO Abbreviation:  -     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2008-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101209214     Medline TA:  Adv Chronic Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-46     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA, USA. Sami.Khella@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Anticoagulants / therapeutic use
Antihypertensive Agents / therapeutic use
Blood Pressure Determination
Comorbidity
Drug Therapy, Combination
Female
Humans
Hypertension / diagnosis,  drug therapy*,  epidemiology*
Incidence
Kidney Failure, Chronic / diagnosis,  epidemiology*,  therapy
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Prognosis
Risk Assessment
Severity of Illness Index
Sex Distribution
Stroke / drug therapy*,  epidemiology*,  prevention & control
Survival Analysis
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Antihypertensive Agents; 0/Platelet Aggregation Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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