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NEUROLOGY 2009;72:899-904
© 2009 American Academy of Neurology

Prevalence of nephroangiosclerosis in patients with fatal stroke

H. Abboud, MD, J. Labreuche, BS, C. Duyckaerts, MD, PhD, J-J Hauw, MD and P. Amarenco, MD

From the Assistance Publique-Hôpitaux de Paris (H.A., C.D., J.-J.H., P.A.), the Department of Neuropathology Raymond Escourolle (C.D., J.-J.H., P.A.), La Salpêtrière Hospital; and INSERM U-698 and Denis Diderot University–Paris VII, the Department of Neurology and Stroke Centre (H.A., J.L., P.A.), Bichat-Claude Bernard University Hospital, Paris, France.

Address correspondence and reprint requests to Professor Pierre Amarenco, Department of Neurology and Stroke Centre, Bichat University Hospital, 46 rue Henri Huchard, 75018 Paris, France pierre.amarenco{at}bch.aphp.fr

Background: Glomerular filtration rate and decline in renal function can be improved by global cardiovascular prevention. However, the prevalence of nephroangiosclerosis in patients with stroke is unknown.

Methods: Using an autopsy data bank, we studied the prevalence of nephroangiosclerosis in 820 consecutive autopsies of neurologic patients.

Results: Among the 820 autopsies, 354 had pathologic evidence of stroke and 466 had other neurologic diseases. Nephroangiosclerosis was found in 39.8% (95% confidence interval [CI], 34.7–44.9) of patients with stroke vs 9.0% (95% CI, 6.4–11.6) in patients with other neurologic diseases. The odds ratio (OR) for nephroangiosclerosis, adjusted for age and sex, was 4.37 (95% CI, 2.92–6.52), and was 2.94 (95% CI, 1.83–4.74) after further adjustment for cardiovascular risk factors. Among the 354 stroke patients, the prevalence of nephroangiosclerosis was similar in patients with brain infarction and in those with brain hemorrhage, in patients with or without parenchymal abnormalities related to small-vessel disease, and across ischemic stroke subtypes except for those with coexisting causes. After multivariable analysis, nephroangiosclerosis was independently associated with age and history of hypertension in patients with stroke, and with age in those with other neurologic diseases.

Conclusions: Nephroangiosclerosis is common in patients with fatal stroke. The association is independent of age, sex, and other cardiovascular risk factors. Impaired renal function should be monitored and prevented in stroke patients with high blood pressure.

CI = confidence interval; OND = neurologic diseases other than stroke; OR = odds ratio; SVD = small-vessel disease.

Supported by SOS-ATTAQUE Cerebrale Association.

Disclosure: The authors report no disclosures.

Received July 30, 2008. Accepted in final form December 17, 2008.






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