Researchers analyzed data from 74,192 hemodialysis (HD) patients, 5,974 peritoneal dialysis (PD) patients, and 669,773 individuals in a reference cohort drawn from the general population and who were older than 18 years, not on dialysis, and without a history of stroke or cancer. In the HD and PD patients, the incidence of hospitalized ischemic stroke was 102.6 and 100.1 per 10,000 person-years, respectively, and the incidence of hospitalized hemorrhagic stroke was 74.7 and 59.4 per 10,000 person-years, respectively. The incidences were significantly higher than those in age- and gender-matched subjects in the reference cohort (42.4 and 13.0 per 10,000 person-years).
In multivariate analysis, HD and PD were associated with a 2.88 and 3.21 times increased risk of ischemic stroke, respectively, and a 6.83 and 6.15 times increased risk of hemorrhagic stroke, respectively, compared with age- and gender-matched individuals in the reference group.
Additionally, the study found that PD was associated with a 25% decreased risk of hemorrhagic stroke compared with HD.
The study, which was led by Jung-Der Wang, MD, ScD, of Natinoal Cheng Kung University College of Medicine in Tainan, was published online ahead of print in the American Journal of Kidney Diseases.
“To our knowledge, our study is the first nationwide population-based cohort study to quantify incidence rates of ischemic and hemorrhagic strokes in patients undergoing HD and PD in comparison to a reference cohort drawn from the general population,” the authors observed.