{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:16:47Z","timestamp":1783487807384,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives. Neurofilament light chain (NfL) is a biomarker of axonal injury with prognostic value in acute ischemic stroke and a promising surrogate outcome marker. This study evaluated whether serum NfL concentrations in ischemic stroke were modified by varying degrees of renal function. Methods. In this prospective, single-center observational study, patients aged 18\u201380 y admitted to the IRCCS Mondino Foundation\u2014Stroke Unit between May 2022 and August 2024 were enrolled. Inclusion criteria were: radiologically confirmed ischemic stroke within 24 h of onset, NIHSS \u2265 1 at admission, pre-stroke mRS &lt; 2, no other neurological comorbidities, and eGFR &gt; 30 mL\/min\/1.73 m2. Serum creatinine was measured on admission, and eGFR was calculated using the CKD-EPI equation. Serum NfL was measured by Ella\u2122 immunoassay at T0 (\u226424 h), T1 (5 \u00b1 3 d), and T2 (7 \u00b1 3 d). Factors associated with serum NfL concentrations were assessed using linear mixed-effects models, and prognostic associations were evaluated by multivariate logistic regression. Results. Ninety-seven patients were included (median age 68.3 y; 39.2% female). Higher NfL levels were independently associated with lower eGFR (\u22122.4% per mL\/min\/1.73 m2 increase; 95% CI \u22123.2% to \u22121.6%; p &lt; 0.001), and higher NIHSS at admission (+3.5% per point; 95% CI 0.7% to 6.4%; p = 0.014). Time from stroke onset was also associated with NfL (p &lt; 0.001). Among patients with 3-month follow-up and T2 measurement (n = 62), the main effects of log10-transformed NfL at T2 and eGFR were not independently associated with unfavorable outcomes. However, a significant log10 NfL \u00d7 eGFR interaction was observed (OR 0.22; 95% CI 0.07\u20130.73; p = 0.014), indicating that the prognostic association of NfL varied according to renal function. Conclusions. Renal function affects serum NfL after ischemic stroke and appears to modify its prognostic association with 3-month outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics16132113","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:05:38Z","timestamp":1783325138000},"page":"2113","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Renal Function and Serum Neurofilament Light Chain in Acute Ischemic Stroke: An Observational Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9868-5997","authenticated-orcid":false,"given":"Federica","family":"Ferrari","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Universit\u00e0 del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy"},{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy"},{"name":"Department of Stroke Unit and Emergency Neurology, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5043-9608","authenticated-orcid":false,"given":"Nicola Davide","family":"Loizzo","sequence":"additional","affiliation":[{"name":"Department of Stroke Unit and Emergency Neurology, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2224-8002","authenticated-orcid":false,"given":"Federico","family":"Mazzacane","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy"},{"name":"Department of Stroke Unit and Emergency Neurology, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5499-8342","authenticated-orcid":false,"given":"Beatrice","family":"Del Bello","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy"},{"name":"Department of Stroke Unit and Emergency Neurology, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Console","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5766-1542","authenticated-orcid":false,"given":"Silvia","family":"Scaranzin","sequence":"additional","affiliation":[{"name":"Neuroimmunology Research Section, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2355-7052","authenticated-orcid":false,"given":"Chiara","family":"Morandi","sequence":"additional","affiliation":[{"name":"Neuroimmunology Research Section, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2288-2000","authenticated-orcid":false,"given":"Matteo","family":"Gastaldi","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Viale Golgi 19, 27100 Pavia, Italy"},{"name":"Neuroimmunology Research Section, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5171-0776","authenticated-orcid":false,"given":"Alessandra","family":"Persico","sequence":"additional","affiliation":[{"name":"Department of Stroke Unit and Emergency Neurology, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5227-1502","authenticated-orcid":false,"given":"Anna","family":"Cavallini","sequence":"additional","affiliation":[{"name":"Department of Stroke Unit and Emergency Neurology, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1136\/jnnp-2018-320106","article-title":"Neurofilament light chain as a biomarker in neurological disorders","volume":"90","author":"Gaetani","year":"2019","journal-title":"J. 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