투석 환자에서 뇌졸중의 임상양상

Abstract

Purpose: Patients with chronic kidney disease are predisposed to having a stroke. However, there are few data regarding the risk factors of stroke for the mortality and outcome in patients with chronic renal failure on dialysis. This retrospective study was conducted to evaluate the risk factors of stroke and its outcome in patients on dialysis at our hospital. Methods: We retrospectively analyzed the data of dialysis patients who developed strokes from March 2001 to March 2009. The stroke was diagnosed on the history, physical examination and computed axial tomography or magnetic resonance imaging of the brain. The types of stroke were divided into ischemic or hemorrhagic stroke. Results: The 120 patients were included in this study. Cerebral ischemia was 80 cases (66.7%) and cerebral hemorrhage was 39 cases (32.5%). One case had cerebral ischemia and hemorrhage simultaneously. Stroke occurred most frequently within 1 year after starting dialysis. Patients with cerebral infarction were older than patients with cerebral hemorrhage. Diabetes mellitus (DM) was more frequent in patient with cerebral infarction. Univariate and multivariate Cox analysis showed old age, hypertension and poor mental status are risk factors of mortality. Diuretics use reduced the mortality. Conclusion: The incidence of ischemic stroke is twice the higher than that of hemorrhagic stroke in the dialysis population. The risk factors of mortality were old age, hypertension, poor mental status and no diuretic use.