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Risk of stroke in elderly dialysis patients

Title
Risk of stroke in elderly dialysis patients
Authors
Han S.S.Ryu D.-R.Joo K.W.Lim C.S.Kim Y.-L.Kang S.-W.Kim Y.S.Kim D.K.
Ewha Authors
류동열
SCOPUS Author ID
류동열scopus
Issue Date
2017
Journal Title
Journal of Korean Medical Science
ISSN
1011-8934JCR Link
Citation
vol. 32, no. 9, pp. 1460 - 1467
Keywords
AgedCardiovascular diseasesChronicKidney failureRenal dialysisStroke
Publisher
Korean Academy of Medical Science
Indexed
SCI; SCIE; SCOPUS; KCI scopus
Abstract
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. © 2017 The Korean Academy of Medical Sciences.
DOI
10.3346/jkms.2017.32.9.1460
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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