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Elevated Plasma Homocysteine Level Increased the Risk of Early Renal Impairment in Acute Ischemic Stroke Patients

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Abstract

Renal insufficiency is associated with the prognosis of acute ischemic stroke (AIS) and homocysteine (Hcy) levels. This study investigated the association between plasma Hcy levels and renal insufficiency in patients with AIS. A total of 987 patients with AIS who had been treated at the First People’s Hospital of Foshan between 2011 and 2014 were retrospectively studied. Based on their cystatin C (Cys C) levels, the patients were divided into the normal renal function group (Cys C ≤ 1.25 mg/L) or the renal impairment group (Cys C > 1.25 mg/L). Multivariate regression analysis was applied to reveal the association between hyperhomocysteinemia (HHcy) and renal impairment. The renal impairment group showed more advanced age of onset, higher percentage of prior stroke and hypertension, higher baseline National Institute of Health Stroke Scale score, lower high-density lipoprotein cholesterol levels, and higher Hcy levels compared with the normal renal function group. A multivariate analysis revealed a relationship between early renal impairment and Hcy levels: an increase of Hcy by 1 μmol/L was associated with an increase of 12–18% of the risk of renal impairment among patients with AIS and HHcy. Patients with AIS and HHcy had a 2.42–3.51 fold increase of the risk of renal impairment compared with patients with normal Hcy level (P < 0.001). In conclusion, patients with stroke and HHcy could be more prone to renal impairment.

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Acknowledgement

The present work was sponsored and funded by the Science and technology project of Guangdong Province, China (No.: 2010B080702029). We thank the chief physicians of the neurology department of the First People’s Hospital of Foshan, Dr. Chengguo Zhang and Dr. Yukai Wang, for their suggestions, assistance, and supervision in study design. We also thank the staff of the neurology and medical care departments for their help in data collection. Lastly, we thank the department of clinical laboratory for providing the laboratory instruments and experiment protocols and assisting in testing the blood samples.

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    1. First People’s Hospital of Foshan, Foshan, 528000, China

      Jingjuan Chen, Guode Li, Zuohang Xu, Chengguo Zhang, Yukai Wang, Haiqun Xie, Yan Shao, Lingmei Peng, Jiancong Lu & Dahua Yuan

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    1. Jingjuan Chen
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    2. Guode Li
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    3. Zuohang Xu
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    4. Chengguo Zhang
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    7. Yan Shao
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    Correspondence to Chengguo Zhang.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    Informed consent was obtained from all individual participants included in the study.

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    Jingjuan Chen, Guode Li and Zuohang Xu contributed equally to this work.

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    Chen, J., Li, G., Xu, Z. et al. Elevated Plasma Homocysteine Level Increased the Risk of Early Renal Impairment in Acute Ischemic Stroke Patients. Cell Mol Neurobiol 37, 1399–1405 (2017). https://doi.org/10.1007/s10571-017-0470-8

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    • DOI: https://doi.org/10.1007/s10571-017-0470-8

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