Evidence map›Paper›PMID 40274401›Full record

ArticleJournal of neurology, neurosurgery, and psychiatry2025

Increased risk of recurrent stroke in patients with impaired kidney function: results of a pooled analysis of individual patient data from the MICON international collaboration.

Jeremy Molad, Kaori Miwa, Philip S Nash, Gareth Ambler, Jonathan Best, Duncan Wilson, Hen Hallevi, Simon Fandler-Höfler, Sebastian Eppinger, Houwei Du and 78 more

Abstract read
In one paragraph

Article in Journal of neurology, neurosurgery, and psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

88 authors.

Jeremy Molad *Department of Stroke & Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel jeremymolad@gmail.com.ORCID http://orcid.org/0000-0001-6868-4849
Kaori Miwa *Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.ORCID http://orcid.org/0000-0002-7948-3636
Philip S Nash *Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, UCL Queen Square Institute of Neurology, London, UK.ORCID http://orcid.org/0000-0003-2428-1575
Gareth AmblerDepartment of Statistical Science, University College London, London, UK.
Jonathan BestStroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK.ORCID http://orcid.org/0000-0002-4243-5753
Duncan WilsonStroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK.
Hen HalleviDepartment of Stroke & Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Simon Fandler-HöflerDepartment of Neurology, Medical University of Graz, Graz, Austria.ORCID http://orcid.org/0000-0001-9043-0378
Sebastian EppingerDepartment of Neurology, Medical University of Graz, Graz, Austria.
Houwei DuStroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK.
Rustam Al-Shahi SalmanCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Hans R JägerStroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, Liverpool, UK.ORCID http://orcid.org/0000-0002-7566-1626
Martina B GoeldlinDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-5800-116X
Morin BeyelerDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-5911-7957
Philipp BückeDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-5204-2016
Marwan El-KoussyInstitute of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital Bern, Bern, Switzerland.
Heinrich Paul MattleDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-7968-1731
Leonidas D PanosDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.
Dianne H K van Dam-NolenRadiology and Nuclear Medicine & Neurology, Erasmus MC, Rotterdam, The Netherlands.ORCID http://orcid.org/0000-0002-4527-3876
Florian DubostBiomedical Imaging Group, Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Jeroen HendrikseRadiology, University Medical Center, Utrecht, The Netherlands.
M Eline KooiDepartment of Radiology and Nuclear Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Werner MessDepartment of Clinical Neurophysiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Paul J NederkoornDepartment of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Masayuki ShiozawaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Nicolas ChristDepartment of Neurology, University Hospital Wurzburg, Wurzburg, Germany.
Maximilian BellutDepartment of Neurology, University Hospital Wurzburg, Wurzburg, Germany.
Sarah GunkelDepartment of Neurology, University Hospital Wurzburg, Wurzburg, Germany.
Christopher KarayiannisPeninsula Clinical School, Peninsula Health, Monash University, Melbourne, Victoria, Australia.
John Van LyMonash Health and Stroke and Ageing Research Group, Monash University, Clayton, Victoria, Australia.
Shaloo SinghalMonash Health and Stroke and Ageing Research Group, Monash University, Clayton, Victoria, Australia.
Lee-Anne SlaterDiagnostic Imaging, Monash Health, Melbourne, Victoria, Australia.
Young Dae KimDepartment of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0001-5750-2616
Tae-Jin SongDepartment of Neurology, Ewha Womans University, Seoul Hospital, Seoul, Korea (the Republic of).ORCID http://orcid.org/0000-0002-9937-762X
Keon-Joo LeeDepartment of Neurology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of).
Jae-Sung LimDepartment of Neurology, University of Ulsan College of Medicine, Songpa-gu, Korea (the Republic of).
Hideo HaraDivision of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan.
Masashi NishiharaDepartment of Radiology, Saga University Faculty of Medicine, Saga, Japan.
Jun TanakaDivision of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan.
Masaaki YoshikawaDivision of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan.
Derya Selcuk DemirelliDepartment of Neurology, Sisli Hamidiye Etfal Teaching and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Zeynep TanriverdiDepartment of Neurology, Ministry of Health İzmir Katip Çelebi University Atatürk Education and Research Hospital, Izmir, Turkey.
Ender UysalDepartment of Radiology, Saglik Bilimleri Universitesi, Istanbul, Turkey.
Shelagh B CouttsNeurosciences, University of Calgary, Calgary, Alberta, Canada.
Francesca M ChappellUK Dementia Institute, University of Edinburgh Institute of Governance, Edinburgh, UK.
Stephen MakinInstitute of Applied Health Sciences, University of Aberdeen, Old Perth Road, UK.
Henry Ka-Fung MakDiagnostic Radiology, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong.ORCID http://orcid.org/0000-0002-2007-0650
Kay Cheong TeoDepartment of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
Debbie Y K WongDepartment of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
Lisa HertNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
Marta KubackaStroke Center Klinik Hirslanden Zürich, University of Basel, Basel, Switzerland.
Philippe LyrerNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
Alexandros A PolymerisNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-9475-2208
Benjamin WagnerNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
Annaelle ZietzNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
Jill M AbrigoDepartment of Radiology & Interventional Radiology, The Chinese University of Hong Kong, HongKong, China.
Cyrus ChengDivision of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Hong Kong.
Winnie C W ChuDepartment of Radiology & Interventional Radiology, The Chinese University of Hong Kong, HongKong, China.
Thomas W H LeungDepartment of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.ORCID http://orcid.org/0000-0001-8193-0709
Suk Fung TsangDepartment of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Brian YiuDepartment of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
David J SeiffgeDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0003-3890-3849
Urs FischerDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.
Simon JungDepartment of Neurology, University Hospital Inselspital Bern, University of Bern, Bern, Switzerland.
Christian EnzingerDepartment of Neurology, Medical University of Graz, Graz, Austria.
Thomas GattringerDepartment of Neurology, Medical University of Graz, Graz, Austria.ORCID http://orcid.org/0000-0002-6065-6576
Daniel BosRadiology and Nuclear Medicine & Neurology, Erasmus MC, Rotterdam, The Netherlands.
Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.ORCID http://orcid.org/0000-0002-8346-9845
Felix FluriDepartment of Neurology, University Hospital Wurzburg, Wurzburg, Germany.
Thanh G PhanMonash Health and Stroke and Ageing Research Group, Monash University, Clayton, Victoria, Australia.
Velandai SrikanthPeninsula Clinical School, Peninsula Health, Monash University, Melbourne, Victoria, Australia.
Ji Hoe HeoDepartment of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of).
Hee-Joon BaeDepartment of Neurology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (the Republic of).
Yusuke YakushijiDepartment of Neurology, Kansai Medical University Medical Center, Hirakata, Japan.
Dilek Necioglu OrkenDepartment of Neurology, Istanbul Arel University, Istanbul, Turkey.
Eric E SmithNeurosciences, University of Calgary, Calgary, Alberta, Canada.
Joanna M WardlawCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.ORCID http://orcid.org/0000-0002-9812-6642
Kui Kai LauDepartment of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
Stefan T EngelterNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
Nils PetersNeurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
Yannie SooDepartment of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.ORCID http://orcid.org/0000-0002-3489-3201
David C WheelerDepartment of Renal Medicine, University College London, London, UK.
Robert J SimisterComprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, UCL Queen Square Institute of Neurology, London, UK.
Natan M BornsteinDepartment of Stroke & Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
David J Werring *Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, UCL Queen Square Institute of Neurology, London, UK.ORCID http://orcid.org/0000-0003-2074-1861
Einor Ben Assayag *Department of Stroke & Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.ORCID http://orcid.org/0000-0003-1645-8246
Masatoshi Koga *Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.ORCID http://orcid.org/0000-0002-6758-4026

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic kidney disease are at increased risk of stroke and frequently have cerebral microbleeds. Whether such patients also encounter an increased risk of recurrent stroke has not been firmly established. We aimed to determine whether impaired kidney function is associated with the risk of recurrent stroke, and microbleed presence, distribution and severity.

methodsWe used pooled data from the Microbleeds International Collaborate Network to investigate associations of impaired kidney function, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m

results11 175 patients (mean age 70.7±12.6, 42% female) were included, of which 2815 (25.2%) had impaired kidney function. Compared with eGFR ≥60, eGFR <60 was associated with a higher risk of the primary outcome (adjusted HR, aHR 1.33 (95% CI 1.14 to 1.56), p<0.001) and higher rates of the recurrent IS (aHR 1.33 (95% CI 1.12 to 1.58)). Reduced eGFR was not associated with ICrH risk (aHR 1.07 (95% CI 0.70 to 1.60)). eGFR was also associated with microbleed presence (adjusted OR, aOR 1.14 (95% CI 1.03 to 1.26)) and severity (aOR 1.17 (95% CI 1.06 to 1.29)). Compared with having no microbleeds, eGFR was lower in those with strictly lobar microbleeds (adjusted mean difference (aMD) -2.10 mL/min/1.73 cm

conclusionsIn patients with IS or transient ischaemic attack, impaired kidney function was associated with a higher risk of recurrent stroke and higher microbleeds burden, compared with those with normal kidney function. Further research is needed to investigate potential additional measures for secondary prevention in this high-risk group.

Indexed as

Ischemic StrokeRenal Insufficiency, ChronicStrokeAgedAged, 80 and overCerebral HemorrhageFemaleGlomerular Filtration RateHumansIntracranial HemorrhagesMaleMiddle AgedRecurrenceRisk FactorsSTROKE

Identifiers

PMID40274401
PMCPMC12418584

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.