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International Urology and Nephrology

, Volume 51, Issue 8, pp 1435–1441 | Cite as

Clinical outcomes of stroke in hemodialysis patients: a retrospective single-center study

  • Keren Cohen-HagaiEmail author
  • Naomi Nacasch
  • Ilan Rozenberg
  • Ze’ev Korzets
  • Yael Einbinder
  • Tali Zitman-Gal
  • Sydney Benchetrit
Nephrology - Original Paper
  • 67 Downloads

Abstract

Purpose

The incidence of stroke in patients undergoing hemodialysis (HD) is eight-to-ten times greater than that of the general population. However, data on the outcome of stroke in these patients are limited.

Methods

In this retrospective observational cohort study, electronic medical records of all patients undergoing HD from 1.1.2014 to 31.12.2017 at Meir Medical Center, Israel, were reviewed. Stroke was defined as a focal neurological deficit of cerebrovascular origin, and confirmed as ischemic or hemorrhagic by computed tomography. Age- and sex-matched HD patients who did not experience a stroke (HD-NS) and hospitalized stroke patients with normal kidney function (NRF-S) served as the two control groups. Baseline demographic, clinical, and laboratory data were collected. Thrombolytic therapy, duration of hospital stay, and mortality were recorded. Functional status at discharge was assessed by the Modified Rankin Scale.

Results

In the cohort study group (HD-S), 52 strokes occurred during 248.3 patient years, an incidence rate of 8.13%, and a stroke rate of 0.19% patients/month. Most strokes in HD patients were ischemic, and only four patients were administered tissue plasminogen activator. HD-S had longer hospitalization than did NRF-S (10.6 ± 9.9 vs. 5.96 ± 5.3 days, p = 0.004) and lower functional status at discharge (Rankin score 3.75 ± 1.57 vs. 2.29 ± 1.89, p < 0.001). HD-S patients had a higher mortality than both HD-NS and NRF-S patients.

Conclusions

Stroke outcome in these patients is dismal with prolonged hospital stay, poor functional status at discharge, very limited response to rehabilitation, and increased mortality.

Keywords

Hemodialysis Stroke Prognosis Outcome 

Notes

Acknowledgements

We thank Faye Schreiber for editing the manuscript and Nava Jelin for statistical analysis.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Nephrology and HypertensionMeir Medical CenterKfar SabaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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