# The impact of intracranial artery stenosis on the prognosis of non-dialysis patients with chronic kidney disease

## TL;DR

This study shows that intracranial artery stenosis is common in non-dialysis chronic kidney disease patients and is linked to higher mortality.

## Contribution

The study identifies specific risk factors and predictors of mortality related to intracranial artery stenosis in non-dialysis CKD patients.

## Key findings

- 45.7% of non-dialysis CKD patients had intracranial artery stenosis.
- Patients with ICAS had significantly lower survival rates compared to those without.
- Posterior circulation stenosis was an independent predictor of all-cause mortality.

## Abstract

To investigate the impact of intracranial artery stenosis (ICAS) on the prognosis of patients with non-dialysis chronic kidney disease (CKD).

We retrospectively analyzed data from non-dialysis CKD patients who were hospitalized in the Department of Nephrology, Xuanwu Hospital, Capital Medical University, from January 2018 to December 2023, and had undergone transcranial color-coded Doppler (TCCD) examination. Follow-up was conducted until July 2025, with all-cause mortality defined as the primary endpoint.

A total of 790 non-dialysis CKD patients were included in the final analysis, of whom 361 (45.7%) had ICAS. Multivariate logistic regression analysis identified advanced age (odds ratio [OR] = 1.029), hypertension (OR = 3.758), diabetes mellitus (OR = 2.504), elevated fibrinogen (OR = 1.263), and lower hemoglobin (OR = 0.987,) as independent correlated factors of ICAS in non-dialysis CKD patients (all p < 0.05). Kaplan–Meier survival curves showed that patients with ICAS had a lower cumulative survival rate (Log-rank test, χ2 = 47.963, p < 0.001). Subgroup analysis revealed that patients with anterior circulation stenosis (ACS), posterior circulation stenosis (PCS), or concurrent anterior and posterior circulation stenosis all had lower survival rates compared to those without ICAS (Log-rank test, χ2 = 60.096, p < 0.001). Multivariate Cox proportional hazards regression analysis demonstrated that advanced age (hazard ratio [HR] = 1.070, 95% CI 1.044–1.096), CKD stages 4–5 (HR = 2.866, 95% CI 1.551–5.296), chronic heart disease (HR = 1.657, 95% CI 1.029–2.666), PCS (HR = 2.538, 95% CI 1.252–5.145), and lower corrected serum calcium (HR = 0.220, 95% CI 0.050–0.969) were independent predictors of all-cause mortality in non-dialysis CKD patients (all p < 0.05).

The prevalence of ICAS in non-dialysis CKD patients was 45.7%. Advanced age, hypertension, diabetes mellitus, elevated fibrinogen, and lower hemoglobin were independent correlated factors for ICAS. Advanced age, CKD stages 4–5, chronic heart disease, PCS, and lower corrected serum calcium were independent predictors of all-cause mortality in this population.