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Updated: May 17, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
[A risk factors for stroke in the patients with chronic kidney disease]
Petar Kes1, Vanja Basić-Kes, Nikolina Basić-Jukić
1Department of Nephrology, Arterial Hypertension and Dialysis, University Hospital Centre Zagreb, Croatia. kespetar@net.hr
Insights
Patients with end-stage renal disease (ESRD) face higher risks of stroke due to advanced vascular disease and dialysis. Managing reversible risk factors is crucial for stroke prevention in chronic kidney disease (CKD).
Area of Science:
- Nephrology
- Neurology
- Vascular Medicine
Context:
- Patients with chronic kidney disease (CKD), particularly end-stage renal disease (ESRD), exhibit accelerated vascular disease compared to the general population.
- ESRD patients show more severe carotid artery atherosclerosis, increasing ischemic stroke risk.
- ESRD is linked to hypertension, bleeding issues, and heparin use during hemodialysis, elevating hemorrhagic stroke risk.
Purpose:
- To review the epidemiology of stroke in chronic kidney disease (CKD) patients.
- To highlight the increased stroke risk associated with dialysis therapies (hemodialysis and peritoneal dialysis).
- To emphasize the importance of managing modifiable risk factors for stroke prevention in CKD.
Summary:
- End-stage renal disease (ESRD) patients have significantly advanced vascular disease, especially in cerebral vasculature, elevating stroke risk.
- Both hemodialysis and peritoneal dialysis are identified as risk factors for stroke in CKD patients.
- Effective stroke prevention in CKD involves addressing reversible factors like hypertension, anemia, dyslipidemia, and diabetes.
Impact:
- This review underscores the heightened vulnerability of CKD and ESRD patients to cerebrovascular events.
- It highlights the need for tailored stroke prevention and management strategies in renal disease populations.
- Understanding these risks can guide clinical practice and improve patient outcomes by focusing on modifiable risk factors.
Abstract:
Patients with chronic kidney disease (CKD) and specially end-stage renal disease (ESRD) have markedly advanced vascular disease when compared to the general population. In particular, several authors have reported more severe atherosclerotic disease of the carotid arteries among ESRD patients than in subjects with normal renal function. This accelerated disease of the cerebral vasculature could increase the risk of ischemic stroke in these patients. Additionally, ESRD is associated with hypertension, a bleeding diathesis, and the routine administration of heparin during hemodialysis, which could increase the risk of hemorrhagic stroke. Dialytic support, including both hemodialysis (HD) and peritoneal dialysis, have been shown to be risk factors for stroke. No studies have assessed stroke risk in renal transplant recipients. Although there are some epidemiologic data for stroke in patients with CKD, there are fewer data for stroke treatment in patients with CKD. In primary and secondary prevention of stroke even in the CKD patients, it has been well established that improved outcomes occur by correcting reversible risk factors, including treating hypertension, secondary hyperparathyroidisam, anemia, dyslipidemia, coagulation abnormalities, malnutrition, inflammation, controlling diabetes, and cardiac disease.
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01:24Chronic Kidney Disease II: Clinical Manifestations
01:28Chronic Kidney Disease III: Interprofessional Care
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