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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Fandler-Höfler, S; Enzinger, C; Kneihsl, M; Pinter, D; Eppinger, S; Obermayer-Pietsch, B; Goritschan, A; Hafner-Giessauf, H; Rosenkranz, AR; Fazekas, F; Gattringer, T.
Early renal dysfunction and fibroblast growth factor-23 in patients with small vessel disease-related stroke.
Sci Rep. 2019; 9(1):15410-15410 Doi: 10.1038/s41598-019-51965-5 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Fandler-Höfler Simon
Gattringer Thomas
Co-Autor*innen der Med Uni Graz
Enzinger Christian
Eppinger Sebastian
Fazekas Franz
Goritschan Anna
Hafner-Giessauf Hildegard Elisabeth
Kneihsl Markus
Obermayer-Pietsch Barbara
Pinter Daniela Theresia
Rosenkranz Alexander

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Interactions between cerebral small vessel disease (CSVD) and renal dysfunction (RD) have been reported, but previous studies were mostly retrospective and limited to measurements of estimated glomerular filtration rate (eGFR). In this prospective, longitudinal study of patients with CSVD-related recent small subcortical infarcts (RSSI), we aimed at a comprehensive exploration of markers of early RD and their association with microvascular brain damage. We investigated 101 stroke patients (mean age: 60.2 ± 10.7 years) with an MRI-confirmed RSSI who underwent follow-up brain MRI 15 months post-stroke. Besides serum creatinine and eGFR, we assessed urinary Albumin-Creatinine Ratio and fibroblast growth factor-23 (FGF-23). RD was classified according to recent Kidney Disease: Improving Global Outcomes criteria. We identified 24 patients with RD, only six patients revealed an eGFR <60 mL/min/1.73 m². RSSI patients with RD more often had severe white matter hyperintensities (WMH, 58% vs. 36%, p = 0.04). CSVD progression was not dependent on RD. However, patients in the highest FGF-23 quartile more frequently had new microangiopathic lesions on follow-up MRI (50% vs. 21%, p = 0.03). Early RD was found in a quarter of RSSI patients and associated with WMH severity, but not CSVD progression. High FGF-23 indicates an increased risk for ongoing microvascular brain damage, warranting further studies.

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