{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:39:37Z","timestamp":1753879177359,"version":"3.41.2"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,16]],"date-time":"2025-02-16T00:00:00Z","timestamp":1739664000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Stroke is a leading cause of death and disability, with substantial healthcare implications. Chronic kidney disease (CKD) is similarly impactful, and emerging evidence links CKD to a higher stroke risk. Despite this, stroke risk assessment in CKD patients remains limited. This study explores the kidney failure risk equation (KFRE) as a predictive tool for ischaemic stroke in CKD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study analysed CKD patients from a healthcare registry, excluding those with prior stroke, end\u2010stage kidney disease, or kidney transplants. Acute ischemic stroke was the primary outcome, with deaths censored. Cox proportional hazards models evaluated associations between the 2\u2010year and 5\u2010year 4\u2010variable KFRE scores and stroke risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 14,794 consecutive patients were included, with a median follow\u2010up of 509\u2009days. The median age of the cohort was 73\u2009years (IQR:14\u2009years), with 6251 females(42.3%), and the majority being of Chinese ethnicity (<jats:italic>n<\/jats:italic>\u2009=\u200910\u2009759,73.5%). During the follow\u2010up period, 155 patients (1.05%) experienced an ischemic stroke event, with a median time to stroke of 265\u2009days (IQR:242\u2009days). The 2\u2010year (HR: 1.38 per 10% increase, 95% CI: [1.17\u20131.63], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 5\u2010year (HR:1.20 per 10% increase, 95% CI: [1.10\u20131.31], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) 4\u2010variable KFRE scores were significantly associated with an increased risk of ischemic stroke. These associations remained significant after adjusting for patient demographics, comorbidities, advanced CKD stage, glycated haemoglobin and lipid parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CKD patients at elevated risk of kidney failure also face a significantly increased risk of acute ischaemic stroke. The KFRE could potentially be integrated into CKD management to assess this risk. Future large prospective cohort studies are necessary to validate these findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.70004","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:09:36Z","timestamp":1739750976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severity of Chronic Kidney Disease as Assessed by the Kidney Failure Risk Equation Is Associated With Incident Acute Ischemic Stroke"],"prefix":"10.1111","volume":"30","author":[{"given":"Benjamin Y. Q.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Division of Neurology, Department of Medicine National University Hospital  Singapore Singapore"},{"name":"Institute of Molecular and Cell Biology Agency for Science Technology and Research (A*STAR)  Singapore Singapore"},{"name":"Henry and Allison McCance Center for Brain Health Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3755-7606","authenticated-orcid":false,"given":"Yong Yi","family":"Tan","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean Shi\u2010An","family":"Lim","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma M. S.","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Division of Neurology, Department of Medicine National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinier W.","family":"Tack","sequence":"additional","affiliation":[{"name":"Henry and Allison McCance Center for Brain Health Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Neurology Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela W. N.","family":"Lim","sequence":"additional","affiliation":[{"name":"Value Driven Outcome Office National University Health System  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shikha","family":"Kumari","sequence":"additional","affiliation":[{"name":"Value Driven Outcome Office National University Health System  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sky W. C.","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"National University Polyclinics National University Health System  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6466-0823","authenticated-orcid":false,"given":"Priyanka","family":"Khatri","sequence":"additional","affiliation":[{"name":"Fast and Chronic Programmes Alexandra Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shilpa","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Nephrology Ng Teng Fong General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard L. L.","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Division of Neurology, Department of Medicine National University Hospital  Singapore Singapore"},{"name":"Institute of Molecular and Cell Biology Agency for Science Technology and Research (A*STAR)  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Henry and Allison McCance Center for Brain Health Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Neurology Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horng\u2010Ruey","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Division of Nephrology, Department of Medicine National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan Ting","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"},{"name":"Division of Nephrology, Department of Medicine National University Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara L. 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