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Abstract Details

Chronic Kidney Disease is Associated with Higher Risk and Worse Outcome after Spontaneous Intracerebral Hemorrhage
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
090
To determine whether CKD is causally associated with risk and outcome of ICH.
Chronic kidney disease (CKD) is known to associate with cerebrovascular disease. The evidence linking CKD to spontaneous intracerebral hemorrhage (ICH) is inconclusive due to possible confounding by comorbidities that frequently coexist in patients with these two diseases.

We conducted a three-stage study that combined observational and genetic components. First, we tested for association between CKD and both ICH risk and poor outcome (modified Ranking Scale 4-6) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) case/control study. Second, we conducted an independent replication of the risk analysis in the UK Biobank (UKB). Third, we implemented a Mendelian Randomization genetic analysis in the UKB using 27 independent CKD-related genetic variants to test for causal associations between CDK and ICH risk.

The ERICH study included 2,954 ICH cases and 2,914 controls with data for CKD and ICH. CKD was independently associated with a 95% increase in risk of ICH (OR 1.95, 95% CI 1.35-2.89; p<0.001) and a 74% increase in risk of poor outcome (OR 1.74, 95% CI 1.18-2.58; p=0.005). Replication in the UK Biobank included 501,195 study participants and 1,341 ICH cases and confirmed this association (OR 1.28, 95% CI 1.01-1.62; p=0.04). Mendelian Randomization analyses indicated that genetically-determined CKD was associated with a 45% increase in ICH risk (OR 1.45, 95% CI 1.07-1.98; p=0.02).
This combined observational/genetic study confirms that CKD is associated with risk and outcome in ICH. Our genetic results indicate that this association represents a causal link. Further studies are needed to identify the specific biological pathways that mediate this causal association.
Authors/Disclosures
Audrey Leasure
PRESENTER 		Ms. Leasure has nothing to disclose.
Kevin N. Vanent Mr. Vanent has nothing to disclose.
No disclosure on file
Daniel Woo, MD, FÂ鶹´«Ã½Ó³»­ (University at Buffalo) The institution of Dr. Woo has received research support from NIH.
Santosh B. Murthy, MD (Weill Cornell Medicine) Dr. Murthy has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CarePoint. Dr. Murthy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alnylam. Dr. Murthy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Stroke and Neurological disorders. The institution of Dr. Murthy has received research support from National Institutes of Health/NINDS.
Hooman Kamel, MD (Weill Cornell Medical College) Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
Jordana Cohen (University of Pennsylvania) Jordana Cohen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Jordana Cohen has received research support from National Institutes of Health. Jordana Cohen has received publishing royalties from a publication relating to health care.
No disclosure on file
Nils Petersen, MD, FÂ鶹´«Ã½Ó³»­ (Yale University) The institution of Dr. Petersen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Silkroad Medical. Dr. Petersen has received research support from NIH.
Lauren H. Sansing, MD Dr. Sansing has nothing to disclose.
Thomas Gill Thomas Gill has nothing to disclose.
Kevin N. Sheth, MD, FÂ鶹´«Ã½Ó³»­ (Yale UniversityDivision of Neuro and Critical Care) Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
Guido J. Falcone, MD (Yale School of Medicine) The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.