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Incidence, etiology, and outcome of stroke in patients on continuous ambulatory peritoneal dialysis

Kazunori Toyoda1, Kenichiro Fujii, Takashi Ando

  • 1Stroke Center, Fukuoka Red Cross Hospital, Japan. toyoda@qmed.hosp.go.jp

Cerebrovascular Diseases (Basel, Switzerland)
|January 7, 2004
PubMed

Insights

Continuous ambulatory peritoneal dialysis (CAPD) patients face a higher stroke risk, often linked to uncontrolled hypertension. This study found CAPD offers no stroke prevention advantage over hemodialysis (HD).

Area of Science:

  • Nephrology
  • Neurology
  • Cardiovascular Medicine

Background:

  • Limited data exists on stroke characteristics in continuous ambulatory peritoneal dialysis (CAPD) patients.
  • Understanding stroke risk factors and outcomes in CAPD is crucial for patient management.

Purpose of the Study:

  • To clarify stroke features in CAPD patients.
  • To identify predictors of stroke onset during chronic CAPD.
  • To compare the stroke prevention efficacy of CAPD versus hemodialysis (HD).

Main Methods:

  • Stroke features were analyzed in 12 CAPD patients (14 attacks) and compared to 137 HD patients.
  • Stroke incidence in CAPD patients was calculated per 1,000 person-years.
  • Mean arterial pressure (MAP) changes and their correlation with stroke occurrence were assessed.

Main Results:

  • Stroke incidence was higher in CAPD patients (15.7/1000 person-years) compared to HD patients (~12).
  • CAPD patients with stroke were younger (52±12 years) than HD patients (62±11 years).
  • Increased MAP post-CAPD introduction independently predicted stroke, particularly hemorrhage; 67% of CAPD stroke patients had poor outcomes.

Conclusions:

  • CAPD patients exhibit elevated stroke risk, primarily due to hypertension and potential overhydration.
  • CAPD does not demonstrate a stroke prevention advantage over HD.
  • Effective hypertension management is critical for CAPD patients to mitigate stroke risk.
Abstract

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