https://scholars.lib.ntu.edu.tw/handle/123456789/578469
標題: | Risk of stroke in long-term dialysis patients compared with the general population | 作者: | Wang H.-H. Hung S.-Y. Sung J.-M. KUAN-YU HUNG Wang J.-D. |
關鍵字: | cerebrovascular disease; end-stage renal disease (ESRD); Hemodialysis; hemorrhagic stroke; ischemic stroke; peritoneal dialysis; renal replacement therapy (RRT); stroke | 公開日期: | 2014 | 出版社: | W.B. Saunders | 卷: | 63 | 期: | 4 | 起(迄)頁: | 604-611 | 來源出版物: | American Journal of Kidney Diseases | 摘要: | Background Patients undergoing maintenance dialysis are at increased risk of stroke. Study Design We performed a nationwide retrospective cohort study to determine the risks for ischemic stroke and hemorrhagic stroke among incident hemodialysis (HD) and peritoneal dialysis (PD) patients in comparison to a reference group in Taiwan. Setting & Participants Data for 74,192 HD patients, 5,974 PD patients, and 669,773 nondialysis individuals who were older than 18 years and had no history of stroke or cancer were retrieved from the National Health Insurance Research Database for 1998-2009. Predictors Patient demographics, comorbid conditions. Outcome First hospitalization for stroke, defined as a diagnosis at discharge (either primary or 1 of 4 secondary diagnoses) of ischemic or hemorrhagic stroke using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results HD and PD patients had higher incidences of hospitalized ischemic stroke (102.6 and 100.1/10,000 person-years) and hemorrhagic stroke (74.7 and 59.4/10,000 person-years) in comparison to the age- and sex-matched reference cohort (42.4 and 13.0/10,000 person-years, respectively). In addition to HD and PD therapy, older age, male sex, diabetes, and hypertension were found to be independent risk factors for both ischemic and hemorrhagic strokes. Using the HD group as the comparison group, we found that PD patients had a lower risk of hemorrhagic stroke (HR, 0.75; 95% CI, 0.58-0.96), and there was no significant difference in risks of ischemic stroke between PD and HD patients after adjusting for all potential confounders and competing risk of death, and matched by propensity scores. Limitations This was a retrospective study, and some important variables were not available. Conclusions Patients undergoing dialysis are at elevated risk of stroke. Patients undergoing PD appear to be less likely to develop hemorrhagic stroke than those undergoing HD. Comprehensive control of hypertension and diabetes is necessary when delivering dialysis treatment. ? 2014 by the National Kidney Foundation, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84896976735&doi=10.1053%2fj.ajkd.2013.10.013&partnerID=40&md5=1338144a993f5cc2c234afffccb8334b https://scholars.lib.ntu.edu.tw/handle/123456789/578469 |
ISSN: | 0272-6386 | DOI: | 10.1053/j.ajkd.2013.10.013 | SDG/關鍵字: | adult; age distribution; article; brain hemorrhage; brain ischemia; cohort analysis; data base; female; hemodialysis; hemodialysis patient; high risk patient; hospitalization; human; hypertension; ICD-9-CM; major clinical study; male; peritoneal dialysis; population research; propensity score; retrospective study; risk factor; sex difference; Taiwan; cerebrovascular disease; end-stage renal disease (ESRD); Hemodialysis; hemorrhagic stroke; ischemic stroke; peritoneal dialysis; renal replacement therapy (RRT); stroke; Aged; Brain Ischemia; Cohort Studies; Comorbidity; Diabetic Nephropathies; Female; Hospitalization; Humans; Intracranial Hemorrhages; Male; Middle Aged; Peritoneal Dialysis; Propensity Score; Renal Dialysis; Renal Insufficiency, Chronic; Retrospective Studies; Risk Factors; Stroke |
顯示於: | 醫學系 |
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