From the Division of Vascular Surgery, Department of Surgery, University of Tampere and Tampere University Hospital, Tampere, Finland; the School of Medicine, Forensic Medicine, University of Tampere and the Laboratory Centre Research Unit, Tampere University Hospital, Tampere, Finland; the Department of Medicine, Tampere University Hospital, Tampere, Finland; the Institute of Health Sciences/Geriatrics, University of Oulu and University Hospital, Unit of General Practice, Oulu, Finland; and the Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
BACKGROUND AND PURPOSE: Cerebral small vessel disease reflected by white matter lesions (WMLs) in MRI and kidney function reflected by estimated glomerular filtration rate (eGFR) is closely associated in patients without stroke. We studied whether eGFR and WMLs predict long-term survival in patients with acute stroke. METHODS: After exclusion of patients with low eGFR (N=5 [1.3%]; /=60 mL/min/1.73 m(2)). Of the patients, 108 (28.6%) had mild, 68 (18.0%) had moderate, and 202 (53.4%) had severe WMLs. In logistic regression analysis adjusted with age and sex, eGFR /=60 mL/min/1.73 m(2) or only mild to moderate WMLs, or both, was associated with improved survival compared with all other combinations. CONCLUSIONS: Cerebral small vessel disease is closely associated with kidney function in patients with acute stroke. Cerebral small vessel disease and kidney function are closely associated predictors of poor poststroke survival.