In:
Nephron, S. Karger AG, Vol. 143, No. 1 ( 2019), p. 43-53
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Few studies have focused on the association between history of ischemic stroke at predialysis stage and mortality after dialysis initiation. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To examine whether history of stroke in incident dialysis patients is associated with mortality, including all-cause and cardiovascular (CV)-related mortality. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The study database was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis, a multicenter, prospective, cohort analysis. We classified patients into 2 groups according to their history of ischemic stroke and compared their outcomes. Propensity scores (PSs) represented the probability of being assigned to a group with or without a history of ischemic stroke. We defined the following outcomes: all-cause mortality; CV-related mortality; non-CV-related mortality; infection-related mortality; and stroke event after dialysis initiation. Factors contributing to the outcomes were examined using stepwise multivariate Cox proportional hazards analysis. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 All-cause mortality was significantly higher in the ischemic stroke group (log-rank test 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). All-cause, non-CV-related, and infection-related mortality and stroke event after dialysis initiation were significantly higher in the ischemic stroke group after PS matching (log-rank test: 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001, & #x3c;0.001, 0.002, and 0.002, respectively). History of ischemic stroke was associated with all-cause mortality in univariate analysis (hazard ratio [HR] 1.85, 95% CI 1.44–2.37). History of ischemic stroke before dialysis initiation was associated with all-cause mortality in multivariate analysis (HR 1.39, 95% CI 1.05–1.85). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The present study revealed that history of ischemic stroke before dialysis initiation was associated with all-cause, non-CV-related, and infection-related mortality and stroke event after dialysis initiation during maintenance dialysis.
Type of Medium:
Online Resource
ISSN:
1660-8151
,
2235-3186
Language:
English
Publisher:
S. Karger AG
Publication Date:
2019
detail.hit.zdb_id:
2810853-X
