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Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease

With both an aging population and greater post-stroke survival, multimorbidity is a growing healthcare challenge, affecting over 40% of stroke patients, and rising rapidly and predictably with increasing age. Commonly defined as the co-occurrence of two or more chronic conditions, multimorbidity bur...

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Autores principales: Kelly, Dearbhla M, Rothwell, Peter M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8521355/
https://www.ncbi.nlm.nih.gov/pubmed/33243088
http://dx.doi.org/10.1177/1747493020975250
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author Kelly, Dearbhla M
Rothwell, Peter M
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Rothwell, Peter M
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description With both an aging population and greater post-stroke survival, multimorbidity is a growing healthcare challenge, affecting over 40% of stroke patients, and rising rapidly and predictably with increasing age. Commonly defined as the co-occurrence of two or more chronic conditions, multimorbidity burden is a strong adverse prognostic factor, associated with greater short- and long-term stroke mortality, worse rehabilitation outcomes, and reduced use of secondary prevention. Chronic kidney disease can be considered as the archetypal comorbidity, being age-dependent and also affecting about 40% of stroke patients. Chronic kidney disease and stroke share very similar traditional cardiovascular risk factor profiles such as hypertension and diabetes, though novel chronic kidney disease-specific risk factors such as inflammation and oxidative stress have also been proposed. Using chronic kidney disease as an exemplar condition, we explore the mechanisms of risk in multimorbidity, implications for management, impact on stroke severity, and downstream consequences such as post-stroke cognitive impairment and dementia.
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spelling pubmed-85213552021-10-19 Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease Kelly, Dearbhla M Rothwell, Peter M Int J Stroke Systematic Review With both an aging population and greater post-stroke survival, multimorbidity is a growing healthcare challenge, affecting over 40% of stroke patients, and rising rapidly and predictably with increasing age. Commonly defined as the co-occurrence of two or more chronic conditions, multimorbidity burden is a strong adverse prognostic factor, associated with greater short- and long-term stroke mortality, worse rehabilitation outcomes, and reduced use of secondary prevention. Chronic kidney disease can be considered as the archetypal comorbidity, being age-dependent and also affecting about 40% of stroke patients. Chronic kidney disease and stroke share very similar traditional cardiovascular risk factor profiles such as hypertension and diabetes, though novel chronic kidney disease-specific risk factors such as inflammation and oxidative stress have also been proposed. Using chronic kidney disease as an exemplar condition, we explore the mechanisms of risk in multimorbidity, implications for management, impact on stroke severity, and downstream consequences such as post-stroke cognitive impairment and dementia. SAGE Publications 2020-11-27 2021-10 /pmc/articles/PMC8521355/ /pubmed/33243088 http://dx.doi.org/10.1177/1747493020975250 Text en © 2020 World Stroke Organization https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Systematic Review
Kelly, Dearbhla M
Rothwell, Peter M
Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
title Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
title_full Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
title_fullStr Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
title_full_unstemmed Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
title_short Impact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
title_sort impact of multimorbidity on risk and outcome of stroke: lessons from chronic kidney disease
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8521355/
https://www.ncbi.nlm.nih.gov/pubmed/33243088
http://dx.doi.org/10.1177/1747493020975250
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