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2017 ; 32
(9
): 1460-1467
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Risk of Stroke in Elderly Dialysis Patients
#MMPMID28776341
Han SS
; Ryu DR
; Joo KW
; Lim CS
; Kim YL
; Kang SW
; Kim YS
; Kim DK
J Korean Med Sci
2017[Sep]; 32
(9
): 1460-1467
PMID28776341
show ga
Despite the current knowledge about the risk of stroke and its related factors in
general population, this issue in elderly patients receiving dialysis remains
unresolved. Firstly, to compare the risk of stroke between hemodialysis (HD) and
peritoneal dialysis (PD), data on 13,065 incident dialysis patients (aged ? 65
years; 10,675 in HD and 2,390 in PD) were retrieved from the Korean Health
Insurance dataset. Secondly, to identify the risk factors of stroke amongst
various clinical and laboratory parameters in HD, 980 elderly patients were
retrospectively analyzed using an independent prospective cohort from 31 dialysis
centers. For a mean duration of 1.8 years (maximum of 5 years), the risk of all
cardiovascular diseases (ischemic heart disease and stroke) did not differ
between HD and PD. However, when analyses were conducted separately by subtype,
the risk of stroke, not ischemic heart disease, was significantly higher in HD
patients than in PD patients. When the risk factors of stroke were probed after
HD for a mean duration of 2.6 years (maximum of 7 years), the absolute dependence
on social support, a previous history of cardiovascular disease, high levels of
low-density lipoprotein cholesterol, and the use of a high number of
anti-hypertensive drugs were identified as being significant. Based on the
discrepancy of stroke risk between modalities and the HD-tailored risk factors of
stroke, the monitoring and management of these factors may be a key strategy to
reduce the risk of stroke in elderly patients receiving dialysis.
|Aged
[MESH]
|Antihypertensive Agents/adverse effects/therapeutic use
[MESH]
free
free
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