대한신장학회

논문분류	춘계학술대회 초록집
제목	Differential Impact of Chronic Kidney Disease on the Risk of Ischemic Versus Hemorrhagic Stroke
저자	Da Woon Kim
출판정보	2026; 2026(1):
키워드	chronic kidney disease, ischemic stroke, hemorrhagic stroke
초록	Objectives: To evaluate the association between chronic kidney disease (CKD) and subtype-specific stroke risk, to assess dose–response relationships across CKD severity, and to determine whether CKD modifies conventional stroke risk-factor patterns in a nationwide population-based cohort. Methods: We conducted a retrospective cohort study using the Korean National Health Insurance Service database. A total of 9,909,045 adults aged ≥20 years without prior stroke or renal replacement therapy were followed from 2014 to 2023. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² or relevant diagnostic codes and was further categorized as mild-to-moderate (eGFR 30–59 mL/min/1.73 m²) and advanced (eGFR <30 mL/min/1.73 m²). The primary outcome was incident acute stroke requiring hospitalization with neuroimaging, classified as ischemic or hemorrhagic. Multivariable Cox proportional hazards models adjusted for demographic factors, health behaviors, and comorbidities were used to estimate adjusted hazard ratios (aHRs). Competing risk analyses were performed treating death as a competing event. Results: CKD was associated with increased risks of both stroke subtypes, but with distinct risk gradient. For ischemic stroke, the risk increased in participants with moderate CKD (aHR, 1.37 [95% CI, 1.32-1.43]) and showed a small amount of increase in the risk of ischemic stroke in those with advanced CKD (aHR, 1.41 [95% CI, 1.28-1.56]). In contrast, the risk of hemorrhagic stroke exhibited a disproportionate surge in advanced CKD (aHR, 1.95 [95% CI, 1.67-2.28]) compared with moderate CKD (aHR, 1.19 [95% CI, 1.10-1.29]). Competing risk analyses confirmed that advanced CKD remained a strong independent predictor of hemorrhagic stroke (subdistribution HR, 1.83 [95% CI, 1.58-2.13]), indicating that the findings were not driven by survival bias. Conclusion: CKD was associated with higher risks of ischemic and hemorrhagic stroke, with distinct severity-dependent risk gradient and heterogeneous risk-factor patterns. These findings support subtype-specific and severity-stratified approaches to stroke prevention in patients with CKD.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정