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Stroke risk associated with chronic kidney disease

https://doi.org/10.21886/2308-6424-2025-13-4-97-106

Abstract

Chronic kidney disease (CKD) is the most significant risk factor in the development of stroke; the latter remains the leading cause of morbidity and mortality globally. CKD patients, especially at the end-stage renal failure and on dialysis, have a very high risk of stroke by 5 – 30 times, with a mortality rate reaching almost 90%. CKD is associated with both ischemic and hemorrhagic stroke. In addition to general risk factors, increased cerebrovascular risk is due to several mechanisms associated with CKD, such as platelet dysfunction, blood clotting disorders, endothelial dysfunction, inflammation, and an increased risk of atrial fibrillation. In addition, CKD can significantly affect the effectiveness of stroke treatment and prevention. Therefore, it is important to study the factors contributing to the development of stroke in this vulnerable population group to apply preventive strategies more effectively. This article examines the epidemiology and pathophysiology of the association between CKD and stroke, as well as the impact of CKD on stroke outcomes. The study aimed to review scientific articles published over the past twenty years on the relationship between CKD and stroke risk. To achieve this objective, a search was used for the keywords «chronic kidney disease», «stroke», «risk», «stroke risk factors» in the databases PubMed, Google Scholar and eLibrary.

About the Authors

F. A. Yusupov
Osh State University
Kyrgyzstan

Furkat A. Yusupov – Dr.Sc.(Med), Full Prof.

Osh



A. F. Yusupov
Osh State University
Kyrgyzstan

Abdulhakim F. Yusupov

Osh



A. A. Yuldashev
Osh State University
Kyrgyzstan

Akmal A. Yuldashev

Osh



References

1. Lee D.B., Huang E., Ward H.J. Tight junction biology and kidney dysfunction. Am J Physiol Renal Physiol. 2006;290(1):F20-34. DOI: 10.1152/ajprenal.00052.2005

2. Tinti F., Lai S., Noce A., Rotondi S., Marrone G., Mazzaferro S., Di Daniele N., Mitterhofer A.P. Chronic Kidney Disease as a Systemic Inflammatory Syndrome: Update on Mechanisms Involved and Potential Treatment. Life (Basel). 2021;11(5):419. DOI: 10.3390/life11050419

3. Asfandiyarov F.R., Kafarov E.S., Stabredov A.V. Topographic anatomy of the renal artery, vein and pelvis. Bulletin of new medical technologies. 2011;18(2):40-41. (In Russian). eLIBRARY ID: 16767890; EDN: OCYFSL

4. Fedin A.I., Kuznetsov M.R., Beresten' N.F., Kholopova E.A., Tugdumov B.V., Rumiantseva E.I., Pavochkina E.S. State of the brain blood flow autoregulation. S.S. Korsakov Journal of Neurology and Psychiatry. 2011;111(1):68-73. (In Russian). eLIBRARY ID: 18891433; EDN: PXKLBT

5. Blinov D.V., Terent'ev A.A. Characterization of biochemical markers of blood-brain-barrier permeability and the functioning of the central nervous system. Neurochemical Journal. 2013;30(3):179. (In Russian). DOI: 10.7868/S1027813313030035

6. Yagmurov O.D. Histohematic barrier of the nephron as a biological system in kidney pathology. Nephrology. 2003;7(1):7-12. (In Russian). eLIBRARY ID: 19414791; EDN: QIWFBH

7. Natochin Yu.V. Integrity. Journal of Higher Nervous Activity named after. I.P. Pavlova. 2018;68(6):775-787. (In Russian). DOI: 10.1134/S0044467718060060

8. Sinyuhin V.N., Rabinovich E.Z., Sokolov M.A., Sivkov A.V. Neurological disorders in chronic kidney disease. Experimental and clinical urology. 2017;(2):92-101. (In Russian). eLIBRARY ID: 29899587; EDN: ZEHPPD

9. Watanabe K., Watanabe T., Nakayama M. Cerebro-renal interactions: impact of uremic toxins on cognitive function. Neurotoxicology. 2014;44:184-193. DOI: 10.1016/j.neuro.2014.06.014

10. Murkamilova ZH.A., Sabirov I.S., Fomin V.V., Aitbaev K.A., Yusupov F.A., Redzhapova N.A., Rayimzhanov Z.R., Murkamilov I.T. Cystatin C and vascular stiffness as markers of nephroand cerebrovascular diseases in the elderly. Herald of KRSU. 2020;20(5):34-44. (In Russian). eLIBRARY ID: 43049134; EDN: NGQQDE

11. Hruska K.A., Mathew S., Lund R., Qiu P., Pratt R. Hyperphosphatemia of chronic kidney disease. Kidney Int. 2008;74(2):148-157. DOI: 10.1038/ki.2008.130

12. Yusupov F.A., Yuldashev A.A. Nervous system and kidneys. Cross-mechanisms of interaction in normal and pathological conditions. Nephrology (Saint-Petersburg). 2023;27(2):29-38. (In Russian). DOI: 10.36485/1561-6274-2023-27-2-29-38

13. Lau W.L., Huisa B.N., Fisher M. The Cerebrovascular-Chronic Kidney Disease Connection: Perspectives and Mechanisms. Transl Stroke Res. 2017;8(1):67-76. DOI: 10.1007/s12975-016-0499-x

14. Murkamilov I.T., Aitbayev K.A., Fomin V.V., Rayimzhanov Z.R., Redzhapova N.A., Yusupov F.A., Aydarov Z.A. Suppression of progression of renal dysfunction and cerebrovascular events: potentials of Atorvastatin. Pharmateka. 2017;(15):74-82. (In Russian). eLIBRARY ID: 30296011; EDN: ZMZDVX

15. Kobayashi M., Hirawa N., Yatsu K., Kobayashi Y., Yamamoto Y., Saka S., Andoh D., Toya Y., Yasuda G., Umemura S. Relationship between silent brain infarction and chronic kidney disease. Nephrol Dial Transplant. 2009;24(1):201-207. DOI: 10.1093/ndt/gfn419

16. Toyoda K. Cerebral small vessel disease and chronic kidney disease. J Stroke. 2015;17(1):31-37.DOI: 10.5853/jos.2015.17.1.31

17. Damulin I.V., Voskresenskaya O.N. Neurological disorders in chronic kidney disease. Neurological Bulletin. 2017;49(1):34-39. (In Russian). eLIBRARY ID: 28770016; EDN: YFOXYT

18. Murkamilov I., Aitbaev K., Murkamilova ZH., Fomin V., Yusupov F. Beta-2-microglobulin as a biomarker in chronic kidney disease. The Scientific Heritage. 2021;(59-2):45-55. (In Russian). DOI: 10.24412/9215-0365-2021-59-2-45-55

19. Chelluboina B., Vemuganti R. Chronic kidney disease in the pathogenesis of acute ischemic stroke. J Cereb Blood Flow Metab. 2019;39(10):1893-1905. DOI: 10.1177/0271678X19866733

20. Mahmoodi B.K., Yatsuya H., Matsushita K., Sang Y., Gottesman R.F., Astor B.C., Woodward M., Longstreth WT. Jr, Psaty B.M., Shlipak M.G., Folsom A.R., Gansevoort R.T., Coresh J. Association of kidney disease measures with ischemic versus hemorrhagic strokes: pooled analyses of 4 prospective community-based cohorts. Stroke. 2014;45(7):1925-1931. DOI: 10.1161/STROKEAHA.114.004900

21. Gadalean F., Simu M., Parv F., Vorovenci R., Tudor R., Schiller A., Timar R., Petrica L., Velciov S., Gluhovschi C., Bob F., Mihaescu A., Timar B., Spasovski G., Ivan V. The impact of acute kidney injury on in-hospital mortality in acute ischemic stroke patients undergoing intravenous thrombolysis. PLoS One. 2017;12(10):e0185589. DOI: 10.1371/journal.pone.0185589

22. Chien S.J., Lin I.C., Hsu C.N., Lo M.H., Tain Y.L. Homocysteine and Arginine-to-Asymmetric Dimethylarginine Ratio Associated With Blood Pressure Abnormalities in Children With Early Chronic Kidney Disease. Circ J. 2015;79(9):2031-2037. DOI: 10.1253/circj.CJ-15-0412

23. Nayak-Rao S., Shenoy M.P. Stroke in Patients with Chronic Kidney Disease…: How do we Approach and Manage it? Indian J Nephrol. 2017;27(3):167-171. DOI: 10.4103/0971-4065.202405

24. Ninomiya T., Perkovic V., Verdon C., Barzi F., Cass A., Gallagher M., Jardine M., Anderson C., Chalmers J., Craig J.C., Huxley R. Proteinuria and stroke: a meta-analysis of cohort studies. Am J Kidney Dis. 2009;53(3):417-425. DOI: 10.1053/j.ajkd.2008.08.032

25. Eldehni M.T., McIntyre C.W.. Are there neurological consequences of recurrent intradialytic hypotension? Semin Dial. 2012;25(3):253-256. DOI: 10.1111/j.1525-139X.2012.01057.x

26. Seliger S.L., Gillen D.L., Longstreth W.T. Jr, Kestenbaum B, Stehman-Breen CO. Elevated risk of stroke among patients with end-stage renal disease. Kidney Int. 2003;64(2):603-609. DOI: 10.1046/j.1523-1755.2003.00101.x

27. Deramecourt V., Slade J.Y., Oakley A.E., Perry R.H., Ince P.G., Maurage C.A., Kalaria R.N. Staging and natural history of cerebrovascular pathology in dementia. Neurology. 2012;78(14):1043-1050. DOI: 10.1212/WNL.0b013e31824e8e7f

28. Gupta J., Mitra N., Kanetsky P.A., Devaney J., Wing M.R., Reilly M., Shah V.O., Balakrishnan V.S., Guzman N.J., Girndt M., Periera B.G., Feldman H.I., Kusek J.W., Joffe M.M., Raj D.S. CRIC Study Investigators. Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin J Am Soc Nephrol. 2012;7(12):1938-1946. DOI: 10.2215/CJN.03500412

29. Gansevoort R.T., Correa-Rotter R., Hemmelgarn B.R., Jafar T.H., Heerspink H.J., Mann J.F., Matsushita K., Wen C.P. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet. 2013;382(9889):339-352. DOI: 10.1016/S0140-6736(13)60595-4

30. Longenecker J.C., Coresh J., Powe N.R., Levey A.S., Fink N.E., Martin A., Klag M.J. Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: the CHOICE Study. J Am Soc Nephrol. 2002;13(7):1918-1927. DOI: 10.1097/01.asn.0000019641.41496.1e

31. Doubal F.N., MacLullich A.M., Ferguson K.J., Dennis M.S., Wardlaw J.M. Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease. Stroke. 2010;41(3):450-454. DOI: 10.1161/STROKEAHA.109.564914

32. Charidimou A., Boulouis G., Pasi M., Auriel E., van Etten E.S., Haley K., Ayres A., Schwab K.M., Martinez-Ramirez S., Goldstein J.N., Rosand J., Viswanathan A., Greenberg S.M., Gurol M.E. MRI-visible perivascular spaces in cerebral amyloid angiopathy and hypertensive arteriopathy. Neurology. 2017;88(12):1157-1164. DOI: 10.1212/WNL.0000000000003746

33. Liu B., Lau K.K., Li L., Lovelock C., Liu M., Kuker W., Rothwell P.M. Age-Specific Associations of Renal Impairment With Magnetic Resonance Imaging Markers of Cerebral Small Vessel Disease in Transient Ischemic Attack and Stroke. Stroke. 2018;49(4):899-904. DOI: 10.1161/STROKEAHA.117.019650

34. Seliger S.L., Longstreth W.T. Jr. Lessons about brain vascular disease from another pulsating organ, the kidney. Stroke. 2008;39(1):5-6. DOI: 10.1161/STROKEAHA.107.496000

35. O'Rourke M.F., Safar M.E. Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension. 2005;46(1):200-204. DOI: 10.1161/01.HYP.0000168052.00426.65

36. Toyoda K., Ninomiya T. Stroke and cerebrovascular diseases in patients with chronic kidney disease. Lancet Neurol. 2014;13(8):823-833. DOI: 10.1016/S1474-4422(14)70026-2

37. Weiner D.E., Tighiouart H., Amin M.G., Stark P.C., MacLeod B., Griffith J.L., Salem D.N., Levey A.S., Sarnak M.J. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol. 2004;15(5):1307-1315. DOI: 10.1097/01.asn.0000123691.46138.e2

38. Kelly D.M., Rothwell P.M. Does Chronic Kidney Disease Predict Stroke Risk Independent of Blood Pressure?: A Systematic Review and Meta-Regression. Stroke. 2019;50(11):3085-3092. DOI: 10.1161/STROKEAHA.119.025442

39. Muntner P., Anderson A., Charleston J., Chen .Z, Ford V., Makos G., O'Connor A., Perumal K., Rahman M., Steigerwalt S., Teal V., Townsend R., Weir M., Wright J.T. Jr. Chronic Renal Insufficiency Cohort (CRIC) Study Investigators. Hypertension awareness, treatment, and control in adults with CKD: results from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2010;55(3):441-451. DOI: 10.1053/j.ajkd.2009.09.014

40. O'Donnell M.J., Chin S.L., Rangarajan S., Xavier D., Liu L., Zhang H., Rao-Melacini P., Zhang X., Pais P., Agapay S., Lopez-Jaramillo P., Damasceno A., Langhorne P., McQueen M.J., Rosengren A., Dehghan M., Hankey G.J., Dans A.L., Elsayed A., Avezum A., Mondo C., Diener H.C., Ryglewicz D., Czlonkowska A., Pogosova N., Weimar C., Iqbal R., Diaz R., Yusoff K., Yusufali A., Oguz A., Wang X., Penaherrera E., Lanas F., Ogah O.S., Ogunniyi A., Iversen H.K., Malaga G., Rumboldt Z., Oveisgharan S., Al Hussain F., Magazi D., Nilanont Y., Ferguson J., Pare G., Yusuf S. INTERSTROKE investigators. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet. 2016;388(10046):761-775. DOI: 10.1016/S0140-6736(16)30506-2

41. Lawes C.M., Bennett D.A., Feigin V.L., Rodgers A. Blood pressure and stroke: an overview of published reviews. Stroke. 2004;35(3):776-785. Corrected and republished in: Stroke. 2004;35(4):1024. DOI: 10.1161/01.STR.0000116869.64771.5A

42. Chen Y.C., Su Y.C., Lee C.C., Huang Y.S., Hwang S.J. Chronic kidney disease itself is a causal risk factor for stroke beyond traditional cardiovascular risk factors: a nationwide cohort study in Taiwan. PLoS One. 2012;7(4):e36332. DOI: 10.1371/journal.pone.0036332

43. Koren-Morag N., Goldbourt U., Tanne D. Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease. Neurology. 2006;67(2):224-228. DOI: 10.1212/01.wnl.0000229099.62706.a3

44. Lee M., Saver J.L., Chang K.H., Liao H.W., Chang S.C., Ovbiagele B. Low glomerular filtration rate and risk of stroke: meta-analysis. BMJ. 2010;341:c4249. DOI: 10.1136/bmj.c4249

45. Karbowska M., Kaminski T.W., Marcinczyk N., Misztal T., Rusak T., Smyk L., Pawlak D. The Uremic Toxin Indoxyl Sulfate Accelerates Thrombotic Response after Vascular Injury in Animal Models. Toxins (Basel). 2017;9(7):229. DOI: 10.3390/toxins9070229

46. Муркамилов И.Т., Сабиров И.С., Фомин В.В., Муркамилова Ж.А., Юсупов Ф.А. Электролитный дисбаланс и аритмии сердца при хронической болезни почек. The Scientific Heritage. 2021;(60-2):55-70.

47. Murkamilov I., Sabirov I., Fomin V., Murkamilova Zh., Yusupov F. Electrolytic imbalance and heart arrhythmies in chronic kidney disease. The Scientific Heritage. 2021;(60-2):55-70. (In Russian). DOI: 10.24412/9215-0365-2021-60-2-55-70

48. Yang Y., Rosenberg G.A. Blood-brain barrier breakdown in acute and chronic cerebrovascular disease. Stroke. 2011;42(11):3323-3328. DOI: 10.1161/STROKEAHA.110.608257

49. Rzhevskaya O.N., Moiseeva A.Y., Esaulenko A.N., Pinchuk A.V., Alidzhanova Kh.G. Chronic kidney disease as a risk factor for acute stroke. Transplantologiya. The Russian Journal of Transplantation. 2021;13(4):382-397. (In Russian). DOI: 10.23873/2074-0506-2021-13-4-382-397


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For citations:


Yusupov F.A., Yusupov A.F., Yuldashev A.A. Stroke risk associated with chronic kidney disease. Urology Herald. 2025;13(4):97-106. (In Russ.) https://doi.org/10.21886/2308-6424-2025-13-4-97-106

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ISSN 2308-6424 (Online)