Cumulative burden of estimated glomerular filtration rate and the risk of intracranial atherosclerosis: A prospective cohort study
Author Identifier (ORCID)
Xiuhua Guo: https://orcid.org/0000-0001-6657-6940
Abstract
Background: Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke. The longitudinal association of the estimated glomerular filtration rate (eGFR) with ICAS is unclear. This study aimed to investigate the association of cumulative eGFR burden with incident ICAS. Methods: In this prospective cohort study, 4032 participants underwent baseline examinations in 2010–2011, 2012–2013, and 2014–2015 and were followed through 31 December 2021. Cumulative eGFR was calculated based on three consecutive measurements obtained from 2010 to 2015. The eGFR slope was estimated using a linear mixed-effects model with eGFR regressed on time from 2010 to 2015. The outcome was defined as the incident ICAS during 2016–2021. Results: The median follow-up time was 3.96 years, during which 374 participants (9.28%) developed ICAS. In the fully adjusted model, single-time-point eGFR < 90 mL/min/1.73 m² (OR: 1.817, 95% CI: 1.343, 2.459), cumulative eGFR burden > 0 (OR: 1.366, 95% CI: 1.041, 1.791), eGFR slope < −10 mL/min/1.73 m²/year (OR: 2.086, 95% CI: 1.480, 2.944), and exposure duration of reduced kidney function > 3 to ≤ 6 years (OR: 1.867, 95% CI: 1.329, 2.622) were significantly associated with increased ICAS risk. Cumulative eGFR burden had a higher net reclassification improvement and integrated discrimination improvement than single-time-point eGFR for predicting ICAS. Conclusion: In this cohort study, single-time-point eGFR, cumulative eGFR burden, eGFR slope, and exposure duration of reduced kidney function were all associated with increased risk of ICAS. Notably, cumulative eGFR burden, which captures both the duration and magnitude of kidney function decline, demonstrated superior predictive value compared with single-time-point eGFR for identifying individuals at risk of ICAS.
Document Type
Journal Article
Date of Publication
1-1-2025
Volume
137
Issue
7
PubMed ID
40910496
Publication Title
Postgraduate Medicine
Publisher
Taylor & Francis
School
Centre for Precision Health / School of Medical and Health Sciences
RAS ID
88163
Funders
National Natural Science Foundation of China (82073668)
Copyright
subscription content
First Page
693
Last Page
701
Comments
Wang, J., Zhao, X., Wang, J., Liu, Y., Li, Y., Zhao, Y., Jin, R., Xu, Z., Wu, Z., Guo, X., & Tao, L. (2025). Cumulative burden of estimated glomerular filtration rate and the risk of intracranial atherosclerosis: A prospective cohort study. Postgraduate Medicine, 137(7), 693–701. https://doi.org/10.1080/00325481.2025.2558350