スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Albuminuria predicts early neurological deterioration in patients with acute ischemic stroke
掲載誌名	正式名：JOURNAL OF THE NEUROLOGICAL SCIENCES ISSNコード：0022-510X/1878-5883
出版社	ELSEVIER SCIENCE BV
巻・号・頁	372,417-420頁
著者・共著者	Takuya Kanamaru,Satoshi Suda,Kanako Muraga,Seiji Okubo,Yoko Watanabe,Syuichi Tsuruoka,Kazumi Kimura
発行年月	2017/01
概要	Background: Reduced glomerular filtration rate (GFR) and albuminuria have been independently associated with an increased risk of stroke and unfavorable long-term outcomes. However, the association between GFR, albuminuria, and early neurological deterioration (END) in patients with ischemic stroke has not been well studied to date. We therefore investigated the ability of estimated GFR (eGFR) and albuminuria to predict END in patients with acute ischemic stroke. Methods: We retrospectively enrolled 294 patients that were admitted to our stroke center with acute ischemic stroke between January 2011 and September 2012. General blood and urine examinations, including eGFR and urinary albumin/creatinine ratio (UACR) measurements, were performed on admission. Kidney dysfunction was defined by a low eGFR value (<60 mL/min/1.73 m(2)) and/or increased albuminuria (>= 30 mg/g creatinine). END was defined as a >= 2-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within 7 days after admission. Results: Kidney dysfunction was diagnosed in 200 of the 294 patients (68.0%). END was observed in 60 patients (20.4%). Age, blood glucose level on admission, UACR on admission, and NIHSS score on admission were significantly associated with END, while no relationship between eGFR on admission and END was identified. A multivariable logistic regression analysis showed that END was positively associated with high UACR (>= 39.6 mg/g creatinine) and a high NIHSS score (6 points). Conclusions: Our data suggest that high UACR on admission may predict END in patients with acute ischemic stroke. Larger prospective studies are required to validate the correlation between albuminuria and END. (C) 2016 Elsevier B.V. All rights reserved.
DOI	10.1016/j.jns.2016.11.007
PMID	27836107