TY  - JOUR
A1  - Tütüncü, Serdar
A1  - Olma, Manuel C.
A1  - Kunze, Claudia
A1  - Krämer, Michael
A1  - Dietzel, Joanna
A1  - Schurig, Johannes
A1  - Filser, Paula
A1  - Pfeilschifter, Waltraud
A1  - Hamann, Gerhard F.
A1  - Büttner, Thomas
A1  - Heuschmann, Peter U.
A1  - Kirchhof, Paulus
A1  - Laufs, Ulrich
A1  - Nabavi, Darius G.
A1  - Röther, Joachim
A1  - Thomalla, Götz
A1  - Veltkamp, Roland
A1  - Eckardt, Kai‐Uwe
A1  - Haeusler, Karl Georg
A1  - Endres, Matthias
T1  - Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack
JF  - European Journal of Neurology
N2  - Background and purpose
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.
Methods
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‐EPI formula) were dichotomized into values of < versus ≥60 ml/min/1.73 m\(^{2}\). eGFR dynamics were classified based on two in‐hospital values as “stable normal” (≥60 ml/min/1.73 m\(^{2}\)), “increasing” (by at least 15% from baseline, second value ≥ 60 ml/min/1.73 m\(^{2}\)), “decreasing” (by at least 15% from baseline of ≥60 ml/min/1.73 m\(^{2}\)), and “stable decreased” (<60 ml/min/1.73 m\(^{2}\)). The composite endpoint (stroke, major bleeding, myocardial infarction, all‐cause death) was assessed after 24 months. We estimated hazard ratios in confounder‐adjusted models.
Results
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 < 60 ml/min/1.73 m\(^{2}\) at baseline (hazard ratio [HR] = 2.2, 95% confidence interval [CI] = 1.40–3.54) as well as decreasing (HR = 1.79, 95% CI = 1.07–2.99) and stable decreased eGFR (HR = 1.64, 95% CI = 1.20–2.24) were independently associated with the composite endpoint. In addition, eGFR < 60 ml/min/1.732 at baseline (HR = 3.02, 95% CI = 1.51–6.10) and decreasing eGFR were associated with all‐cause death (HR = 3.12, 95% CI = 1.63–5.98).
Conclusions
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.
KW  - kidney function
KW  - prognosis
KW  - stroke
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-287271
VL  - 29
IS  - 9
SP  - 2716
EP  - 2724
ER  - 
TY  - JOUR
A1  - Dannewitz, Bettina
A1  - Sommerer, Claudia
A1  - Stölzel, Peggy
A1  - Baid‐Agrawal, Seema
A1  - Nadal, Jennifer
A1  - Bärthlein, Barbara
A1  - Wanner, Christoph
A1  - Eckardt, Kai‐Uwe
A1  - Zeier, Martin
A1  - Schlagenhauf, Ulrich
A1  - Krane, Vera
A1  - Jockel‐Schneider, Yvonne
T1  - Status of periodontal health in German patients suffering from chronic kidney disease—Data from the GCKD study
JF  - Journal of Clinical Periodontology
N2  - Aim
To assess the prevalence and severity of periodontitis in patients with moderate chronic kidney disease (CKD) and comparing the results with the self‐reported periodontitis awareness of the study subjects.

Material and methods
The periodontal status of 270 patients with moderate CKD randomly selected from a cohort of 5,217 subjects participating in the prospective observational German Chronic Kidney Disease (GCKD) project was analysed by recording bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL). Furthermore, the awareness of the study subjects of their periodontal conditions was evaluated by a self‐reported questionnaire.

Results
24.4% of the CKD study patients showed no or only mild signs of periodontal disease, 47.6% displayed moderate and 27% severe periodontitis. Questionnaire data revealed that 62.3% of the study subjects with severe periodontitis were not aware of the presence of the disease, 44.4% denied having received any systematic periodontal therapy so far, although 50% of them indicated to visit their dentist regularly for professional tooth cleanings.

Conclusion
While the clinical study data confirm an increased prevalence of periodontitis in CKD patients, their self‐reported awareness of periodontitis was low.
KW  - chronic kidney disease
KW  - observational cohort study
KW  - periodontitis
KW  - risk factors
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-217821
VL  - 47
IS  - 1
SP  - 19
EP  - 29
ER  -