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Changes in the Risk of Stroke in Dialysis Patients: A Retrospective Analysis over the Last 40 Years

Toshiya Aono1, Yuki Shinya1,2, Satoru Miyawaki2

  • 1Department of Neurosurgery, Teraoka Memorial Hospital, Hiroshima 729-3103, Japan.

Toxins
|June 2, 2021
PubMed

Insights

Stroke risk is high in hemodialysis patients, with diabetic nephropathy increasing risk. While advanced dialysis helps, aging and diabetic nephropathy remain significant concerns for stroke and mortality.

Area of Science:

  • Nephrology
  • Neurology
  • Cardiovascular Medicine

Background:

  • Hemodialysis patients face a high incidence of stroke, with underlying risk factors poorly understood.
  • Understanding stroke incidence and evolving risk factors in hemodialysis is crucial for patient outcomes.

Purpose of the Study:

  • To analyze stroke incidence in hemodialysis patients.
  • To identify changes and key factors associated with stroke risk over time in this population.

Main Methods:

  • Retrospective analysis of data from 291 hemodialysis patients.
  • Statistical analysis including hazard ratios and confidence intervals to assess risk factors.

Main Results:

  • Cumulative stroke incidence reached 21.6% at 10 years and 31.5% at 20 years.
  • Diabetic nephropathy significantly elevated stroke risk (HR 2.24 for overall, HR 2.16 for ischemic).
  • Online hemodiafiltration (HDF) was associated with reduced overall and ischemic stroke risk (HR 0.13 and HR 0.08, respectively).
  • Diabetic nephropathy and age >80 years at hemodialysis initiation were linked to increased stroke and/or death events.

Conclusions:

  • Stroke risk in hemodialysis patients increases over time, partly due to rising rates of diabetic nephropathy.
  • Despite technological advancements in dialysis, other risk factors like diabetic nephropathy and aging continue to pose significant threats.
  • The increasing prevalence of aging among dialysis patients suggests a continued concern for elevated stroke and mortality rates.

Keywords:
diabetes mellitusdiabetic nephropathydialysisstrokeuremic toxin

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