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Hemorrhagic stroke in chronic dialysis patients

Mei-Fen Pai1, Shih-Ping Hsu, Yu-Sen Peng

  • 1Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan, R.O.C.

Renal Failure
|August 4, 2004
PubMed

Insights

Hemorrhagic stroke in dialysis patients has a poor prognosis, with higher mortality in those on peritoneal dialysis (PD) after stroke. Lower hemoglobin levels also indicate a worse outcome for these patients.

Area of Science:

  • Nephrology
  • Neurology
  • Critical Care Medicine

Background:

  • Chronic dialysis patients face unique challenges with cerebrovascular events.
  • Hemorrhagic stroke (CH) in this population requires specific clinical understanding.
  • Prognostic factors for hemorrhagic stroke in dialysis patients are not well-defined.

Purpose of the Study:

  • To retrospectively analyze clinical profiles, disease course, and management of hemorrhagic stroke in chronic dialysis patients.
  • To identify factors influencing the prognosis of hemorrhagic stroke in this cohort.
  • To evaluate outcomes based on dialysis modality (hemodialysis vs. peritoneal dialysis).

Main Methods:

  • Retrospective study of chronic dialysis patients admitted with acute hemorrhagic stroke (January 1991-June 1999).
  • Detailed review of clinical characteristics, laboratory data, and management records.
  • Analysis of outcomes, including mortality and dialysis modality post-stroke.

Main Results:

  • 16 patients (9 male, 7 female, average age 59.4 years) were analyzed.
  • High prevalence of comorbidities: hypertension (100%), Diabetes Mellitus (56%), prior cerebrovascular accidents (56%).
  • Overall mortality was 44%; patients on peritoneal dialysis (PD) post-stroke had significantly higher mortality (75%) compared to those on hemodialysis (HD) (12.5%).

Conclusions:

  • Hemorrhagic stroke carries a poor prognosis in chronic dialysis patients.
  • Peritoneal dialysis post-hemorrhagic stroke and lower presenting hemoglobin levels are associated with worse outcomes.
  • Neurological deterioration is the primary cause of death, often occurring rapidly.
Abstract

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