{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:10:22Z","timestamp":1780528222587,"version":"3.54.1"},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Impaired kidney function is associated with an increased risk of vascular events in acute stroke patients, when assessed by single measurements of estimated glomerular filtration rate (eGFR). It is unknown whether repeated measurements provide additional information for risk prediction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The MonDAFIS (Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke) study randomly assigned 3465 acute ischemic stroke patients to either standard procedures or an additive Holter electrocardiogram. Baseline eGFR (CKD\u2010EPI formula) were dichotomized into values of &lt; versus \u226560\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>. eGFR dynamics were classified based on two in\u2010hospital values as \u201cstable normal\u201d (\u226560\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>), \u201cincreasing\u201d (by at least 15% from baseline, second value \u2265\u200960\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>), \u201cdecreasing\u201d (by at least 15% from baseline of \u226560\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>), and \u201cstable decreased\u201d (&lt;60\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>). The composite endpoint (stroke, major bleeding, myocardial infarction, all\u2010cause death) was assessed after 24\u2009months. We estimated hazard ratios in confounder\u2010adjusted models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Estimated glomerular filtration rate at baseline was available in 2947 and a second value in 1623 patients. After adjusting for age, stroke severity, cardiovascular risk factors, and randomization, eGFR\u2009&lt;\u200960\u2009ml\/min\/1.73\u2009m<jats:sup>2<\/jats:sup> at baseline (hazard ratio [HR]\u00a0=\u00a02.2, 95% confidence interval [CI]\u00a0=\u00a01.40\u20133.54) as well as decreasing (HR\u00a0=\u00a01.79, 95% CI\u00a0=\u00a01.07\u20132.99) and stable decreased eGFR (HR\u00a0=\u00a01.64, 95% CI\u00a0=\u00a01.20\u20132.24) were independently associated with the composite endpoint. In addition, eGFR\u2009&lt;\u200960\u2009ml\/min\/1.73<jats:sup>2<\/jats:sup> at baseline (HR\u00a0=\u00a03.02, 95% CI\u00a0=\u00a01.51\u20136.10) and decreasing eGFR were associated with all\u2010cause death (HR\u00a0=\u00a03.12, 95% CI\u00a0=\u00a01.63\u20135.98).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In addition to patients with low eGFR levels at baseline, also those with decreasing eGFR have increased risk for vascular events and death; hence, repeated estimates of eGFR might add relevant information to risk prediction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15431","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T13:50:25Z","timestamp":1654177825000},"page":"2716-2724","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5057-7487","authenticated-orcid":false,"given":"Serdar","family":"T\u00fct\u00fcnc\u00fc","sequence":"first","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel C.","family":"Olma","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Department of Neurology with Experimental Neurology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Kunze","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Dietzel","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Schurig","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Filser","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-8842","authenticated-orcid":false,"given":"Waltraud","family":"Pfeilschifter","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Frankfurt  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard F.","family":"Hamann","sequence":"additional","affiliation":[{"name":"Department of Neurology BKH G\u00fcnzburg  G\u00fcnzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"B\u00fcttner","sequence":"additional","affiliation":[{"name":"Department of Neurology Hans\u2010Susemihl Hospital  Emden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter U.","family":"Heuschmann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Epidemiology and Biometry University of W\u00fcrzburg  W\u00fcrzburg Germany"},{"name":"Comprehensive Heart Failure Center and Clinical Trial Center W\u00fcrzburg University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"German Atrial Fibrillation Network  M\u00fcnster Germany"},{"name":"Institute of Cardiovascular Sciences College of Medical and Dental Sciences, Medical School University of Birmingham  Birmingham UK"},{"name":"Departments of Cardiology UHB and SWBH National Health Service Trusts  Birmingham UK"},{"name":"University Heart and Vascular Center Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Laufs","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Leipzi  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darius G.","family":"Nabavi","sequence":"additional","affiliation":[{"name":"Department of Neurology Vivantes Hospital Neuk\u00f6lln  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"R\u00f6ther","sequence":"additional","affiliation":[{"name":"Department of Neurology Asklepios Clinic Altona  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6tz","family":"Thomalla","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Veltkamp","sequence":"additional","affiliation":[{"name":"Department of Neurology Alfried Krupp Hospital  Essen Germany"},{"name":"Department of Brain Sciences Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai\u2010Uwe","family":"Eckardt","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl Georg","family":"Haeusler","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Endres","sequence":"additional","affiliation":[{"name":"Center for Stroke Research Berlin Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Department of Neurology with Experimental Neurology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Berlin Institute of Health  Berlin Germany"},{"name":"German Center for Neurodegenerative Diseases Partner Site Berlin  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