Impact of Renal Function on Serum Neurofilament Light Chain Levels in Acute Ischemic Stroke Patients: An Observational Cohort Study

Introduction This database includes the raw data linked with the paper “Impact of Renal Function on Serum Neurofilament Light Chain Levels in Acute Ischemic Stroke Patients: An Observational Cohort Study”. Neurofilament light chain (NfL) is a sensitive biomarker of axonal injury with established prognostic value in acute ischemic stroke. However, circulating NfL concentrations can be influenced by renal function, potentially affecting their interpretability. This study aimed to investigate the impact of renal function on serum NfL levels in acute ischemic stroke patients and to identify clinical determinants influencing NfL dynamics in the early post-stroke phase. Methods In this prospective, single-center observational study, we enrolled 97 adult patients with radiologically confirmed acute ischemic stroke within 24 hours of onset, admitted to the IRCCS Mondino Foundation Stroke Unit (May 2022–August 2024). Serum NfL was quantified using the Ella™ automated immunoassay system at admission (T0), 5±3 days (T1), and 8±3 days (T2). Renal function was assessed by serum creatinine and estimated glomerular filtration rate (eGFR, CKD-EPI formula). Clinical variables included NIHSS at admission, vascular risk factors, and pre-stroke mRS. Linear mixed-effects models were used to evaluate longitudinal predictors of serum NfL, with time, eGFR, and stroke severity as fixed effects. Results (in brief) Serum NfL concentrations increased significantly over time after stroke onset (median 27.4 → 118 pg/mL from T0 to T2, p < 0.001). Lower eGFR was independently associated with higher NfL levels, with a 2.4% decrease in NfL for each unit increase in eGFR (p < 0.001). Time from onset and NIHSS score were additional independent predictors: NfL rose by 26% per day and 4% per NIHSS point. These findings indicate that renal function, stroke severity, and time since onset jointly influence serum NfL dynamics, underscoring the need to adjust for renal function when interpreting NfL levels in acute stroke.