Please use this identifier to cite or link to this item: https://hdl.handle.net/1/1289
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dc.contributor.authorSturm, Jonathan-
dc.contributor.otherZheng, D.-
dc.contributor.otherSato, S.-
dc.contributor.otherArima, H.-
dc.contributor.otherHeeley, E.-
dc.contributor.otherDelcourt, C.-
dc.contributor.otherCao, Y.-
dc.contributor.otherChalmers, J.-
dc.contributor.otherAnderson, C.-
dc.date.accessioned2019-03-18T04:59:35Zen
dc.date.available2019-03-18T04:59:35Zen
dc.date.issued2016-07-
dc.identifier.citation68(1):94-102en
dc.identifier.issn0272-6386en
dc.identifier.urihttps://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1289en
dc.description.abstractBACKGROUND: The kidney-brain interaction has been a topic of growing interest. Past studies of the effect of kidney function on intracerebral hemorrhage (ICH) outcomes have yielded inconsistent findings. Although the second, main phase of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2) suggests the effectiveness of early intensive blood pressure (BP) lowering in improving functional recovery after ICH, the balance of potential benefits and harms of this treatment in those with decreased kidney function remains uncertain. STUDY DESIGN: Secondary analysis of INTERACT2, which randomly assigned patients with ICH with elevated systolic BP (SBP) to intensive (target SBP<140mmHg) or contemporaneous guideline-based (target SBP<180mmHg) BP management. SETTING & PARTICIPANTS: 2,823 patients from 144 clinical hospitals in 21 countries. PREDICTORS: Admission estimated glomerular filtration rates (eGFRs) of patients were categorized into 3 groups based on the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation: normal or high, mildly decreased, and moderately to severely decreased (>90, 60-90, and <60mL/min/1.73m(2), respectively). OUTCOMES: The effect of admission eGFR on the primary outcome of death or major disability at 90 days (defined as modified Rankin Scale scores of 3-6) was analyzed using a multivariable logistic regression model. Potential effect modification of intensive BP lowering treatment by admission eGFR was assessed by interaction terms. RESULTS: Of 2,623 included participants, 912 (35%) and 280 (11%) had mildly and moderately/severely decreased eGFRs, respectively. Patients with moderately/severely decreased eGFRs had the greatest risk for death or major disability at 90 days (adjusted OR, 1.82; 95% CI, 1.28-2.61). Effects of early intensive BP lowering were consistent across different eGFRs (P=0.5 for homogeneity). LIMITATIONS: Generalizability issues arising from a clinical trial population. CONCLUSIONS: Decreased eGFR predicts poor outcome in acute ICH. Early intensive BP lowering provides similar treatment effects in patients with ICH with decreased eGFRs.en
dc.description.sponsorshipNeurologyen
dc.description.sponsorshipRenalen
dc.subjectNeurologyen
dc.subjectStrokeen
dc.subjectDrug Therapyen
dc.titleEstimated GFR and the Effect of Intensive Blood Pressure Lowering After Acute Intracerebral Hemorrhageen
dc.typeJournal Articleen
dc.identifier.doi10.1053/j.ajkd.2016.01.020en
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/26948991en
dc.description.affiliatesCentral Coast Local Health Districten
dc.description.affiliatesGosford Hospitalen
dc.description.affiliatesWyong Hospitalen
dc.identifier.journaltitleAmerican Journal of Kidney Diseasesen
dc.type.studyortrialRandomized Controlled Clinical Trial/Controlled Clinical Trialen
dc.originaltypeTexten
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.cerifentitytypePublications-
Appears in Collections:Neurology
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