Glomerular filtration rate and the risk of stroke

Stroke is a common cause of death and disability that affects not only the patient but his or her family and the broader community. Prevention of stroke, through the identification and management of risk factors, is thus a public health priority.

Chronic kidney disease is common, particularly in people at high risk of cardiovascular disease.1 Chronic kidney disease is a strong risk factor for cardiovascular events,2 even after adjusting for other known risk factors. Much less is known about the relation between chronic kidney disease and specific types of cardiovascular events, such as stroke. This is important because stroke has several subtypes that may have different associations with individual risk factors and therefore treatments. For example, lipid lowering treatments3 and antiplatelet treatment4 protect against cardiovascular events overall but may increase the risk of haemorrhagic stroke[f1].5

In the linked systematic review (doi:10.1136/bmj.c4249),6 Lee and colleagues assess the association between kidney function, defined by estimated glomerular filtration rate (eGFR), and the subsequent …