1.Chronic Kidney Disease As a Risk Factor of Stroke
Kenji KIKUCHI ; Kazuo SUZUKI ; Hisashi KOJIMA ; Katsuya FUTAWATARI ; Kenji MURAISHI ; Yoshitaka SUDA ; Junkoh SASAKI ; Susumu FUSHIMI ; Yasunari OTAWARA ; Toshirou OOTSUKA ; Hidehiko ENDO ; Makie TANAKA ; Naoko SUZUKI ; Kimiyo TAKAHASHI ; Yuko KIKUCHI ; Kozue IKEDA ; Mutsumi NITTA ; Mikiko FUJIWARA ; Miyuki NANBU ; Akiko TAKAHASHI ; Shousaku OGASAWARA
Journal of the Japanese Association of Rural Medicine 2014;63(4):596-605
Chronic kidney disease (CKD) has recently been reported to be an independent risk factor for stroke. However, a detailed analysis was yet to be conducted according to stroke subtype. We attempted to determine the risk factors for stroke using data from the “specific health checkup” for metabolic syndrome conducted by the 9 hospitals affiliated with the Akita Prefectural Federation of Agricultural Cooperatives, and evaluate and determine the risk factors for stroke. There were 401 patients who had undergone metabolic syndrome checkups from 2007 and 2010 and suffered from stroke afterwards within 3 years after the screening. The controls were all 69,407 subjects who were screened during the same period. The predictors examined were sex, age, blood pressure, BMI, cholesterol values (HDL・LDL), history of diabetes mellitus, presence of atrial fibrillation, CKD, and drinking and smoking habits. Analysis was conducted using logistic regression. The risk factors for stroke as a whole were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking history. For cerebral infarction, the risk factors were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking habit. The risk factors for cerebral hemorrhage were age, blood pressure, and CKD. For subarachnoid hemorrhage, the risk factors were female sex, age, blood pressure, low HDLemia, and CKD. In conclusion, CKD is an independent risk factor for the 3 subtypes of stroke, and in particular plays an important role as a higher risk factor for cerebral hemorrhage. Smoking cessation and controls of blood pressure, diabetes and atrial fibrillation are the important measures for stroke prevention. In addition, the further intervention should also be targeted to those with the result of CKD revealed by specific health checkups.
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