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Background And Purpose: The association between chronic kidney disease (CKD) grade and stroke severity or prognosis is still controversial. We investigated the relationship between CKD stage and stroke severity on admission and its influence on prognosis.
Methods: Using a regional stroke registry, the clinical characteristics of acute ischemic stroke patients were investigated in each CKD stage (G1-G5). The relationship between CKD stage and the National Institutes of Health Stroke Scale (NIHSS) score was examined in stratified analyses under the presence or absence of various factors. Multiple logistic regression analyses to identify predictors for an unfavorable prognosis or death were performed.
Results: Of 10,104 patients, 1,056 (10 %) were CKD stage G1, 3,797 (38 %) were stage G2, 4,137 (41 %) were stage G3, 678 (7 %) were stage G4, and 436 (4 %) were stage G5. The NIHSS score was the highest in patients with stage G4 (median, 10; interquartile range, 4-22), compared to those with G1 (3; 1-8), G2 (3; 2-9), G3 (6; 2-16), and G5 (5; 2-14). Similar results were obtained on multiple logistic regression analysis including potential confounders. As to outcome at discharge, a modified Rankin Scale score of ≥3 was more frequently observed in stage G4 patients. However, the independent relationships diminished after multiple logistic regression analyses including stroke severity on admission as an independent variable.
Conclusion: Stroke severity on admission was the highest in patients with CKD stage G4 compared to the other stages, which was possibly related to an unfavorable prognosis and mortality.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2025.108391 | DOI Listing |
Brain
September 2025
Center for Brain Plasticity and Recovery, Center for Aphasia Research and Rehabilitation, Departments of Neurology and Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC, 20057 USA.
The role of the right hemisphere in aphasia recovery has been controversial since the 19th century. Imaging studies have sometimes found increased activation in right hemisphere regions homotopic to canonical left hemisphere language regions, but these results have been questioned due to small sample sizes, unreliable imaging tasks, and task performance confounds that affect right hemisphere activation levels even in neurologically healthy adults. Several principles of right hemisphere language recruitment in aphasia have been proposed based on these studies: that the right hemisphere is recruited primarily by individuals with severe left hemisphere damage, that transcallosal disinhibition results in recruitment of right hemisphere regions homotopic to the lesion, and that increased right hemisphere activation diminishes to baseline levels over time.
View Article and Find Full Text PDFTurk Kardiyol Dern Ars
September 2025
Department of Cardiology, Dicle University School of Medicine, Diyarbakır, Turkiye.
Objective: Originally designed to evaluate stroke risk in individuals with atrial fibrillation unrelated to valvular disease, the CHA2DS2-VASc score (Congestive heart failure, Hypertension, Age ≥ 75 years, Diabetes mellitus, prior Stroke/transient ischemic attack/systemic embolism, Vascular disease, Age 65-74 years, and Sex category - female) is now additionally utilized for the prognostic evaluation of cardiovascular diseases. This study aimed to evaluate the predictive role of the CHA2DS2-VASc score for lesion severity and long-term survival outcomes in individuals with peripheral artery disease (PAD).
Method: This retrospective analysis included 784 patients diagnosed with PAD via computed tomography (CT) angiography, consecutively enrolled from two medical centers.
J Craniofac Surg
September 2025
Weifang People's Hospital, Shandong Second Medical University, Weifang, China.
Large vessel occlusion (LVO)-induced acute ischemic stroke (AIS) manifests with abrupt onset and critical severity, primarily caused by cerebral artery atherosclerosis or cardiogenic embolism leading to luminal stenosis or occlusion. The authors report a case of acute massive cerebral infarction caused by occlusion of the left middle cerebral artery (MCA) and missed the time window for thrombolysis, in which spontaneous recanalization of the MCA was achieved after 1 week of conservative treatment. After 2 months of rehabilitation training, neurological functions and other symptoms significantly improved.
View Article and Find Full Text PDFNeural Plast
September 2025
Department of Anesthesiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Astrocytes play a crucial role in ensuring neuronal survival and function. In stroke, astrocytes trigger the unfolded protein response (UPR) to restore endoplasmic reticulum homeostasis. Mesencephalic astrocyte-derived neurotrophic factor (MANF), a newly identified endoplasmic reticulum stress-induced neurotrophic factor, attenuates cerebral ischemic injury by reducing inflammatory responses.
View Article and Find Full Text PDFClin Kidney J
September 2025
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Background: Steroidal mineralocorticoid receptor antagonists (MRAs), including spironolactone, effectively treat resistant hypertension, reduce proteinuria and lower mortality in heart failure with reduced ejection fraction. However, their long-term effects in chronic kidney disease (CKD) remain unclear. This study investigated spironolactone's impact on end-stage renal disease (ESRD), major adverse cardiovascular events (MACE), hyperkalemia and mortality in CKD patients.
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