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The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease

Background: The incidence of stroke after kidney transplantation is poorly understood. Our study aimed to determine the incidence and predictors of stroke as well as mortality from stroke in kidney transplant recipients (KTRs). Methods: This retrospective cohort study used the National Health Insura...

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Autores principales: Huang, Shih-Ting, Yu, Tung-Min, Chuang, Ya-Wen, Chung, Mu-Chi, Wang, Chen-Yu, Fu, Pin-Kuei, Ke, Tai-Yuan, Li, Chi-Yuan, Lin, Cheng-Li, Wu, Ming-Ju, Kao, Chia-Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388105/
https://www.ncbi.nlm.nih.gov/pubmed/30682846
http://dx.doi.org/10.3390/ijerph16030326
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author Huang, Shih-Ting
Yu, Tung-Min
Chuang, Ya-Wen
Chung, Mu-Chi
Wang, Chen-Yu
Fu, Pin-Kuei
Ke, Tai-Yuan
Li, Chi-Yuan
Lin, Cheng-Li
Wu, Ming-Ju
Kao, Chia-Hung
author_facet Huang, Shih-Ting
Yu, Tung-Min
Chuang, Ya-Wen
Chung, Mu-Chi
Wang, Chen-Yu
Fu, Pin-Kuei
Ke, Tai-Yuan
Li, Chi-Yuan
Lin, Cheng-Li
Wu, Ming-Ju
Kao, Chia-Hung
author_sort Huang, Shih-Ting
collection PubMed
description Background: The incidence of stroke after kidney transplantation is poorly understood. Our study aimed to determine the incidence and predictors of stroke as well as mortality from stroke in kidney transplant recipients (KTRs). Methods: This retrospective cohort study used the National Health Insurance Research Database in Taiwan to study KTRs (N = 4635), patients with end-stage renal disease (ESRD; N = 69,297), and patients from the general population who were chronic kidney disease (CKD)-free and matched by comorbidities (N = 69,297) for the years 2000 through 2010. The risk of stroke was analyzed using univariate and multivariate Cox regression models and compared between study cohorts. Findings: Compared with the ESRD subgroup, KTRs had a significantly lower risk of overall stroke (adjusted hazard ratio (aHR) = 0.37, 95% confidence interval (CI) = 0.31–0.44), ischemic stroke (aHR = 0.45, 95% CI = 0.37–0.55), and hemorrhagic stroke (aHR = 0.20, 95% CI = 0.14–0.29). The risk patterns for each type of stroke in the KTR group were not significantly different than those of the CKD-free control subgroup. The predictors of stroke were age and diabetes in KTRs. All forms of stroke after transplantation independently predicted an increased risk of subsequent mortality, and the strongest risk was related to hemorrhagic events. Interpretation: KTRs had a lower risk of stroke than ESRD patients, but this risk was not significantly different from that of the CKD-free comorbidities-matched general population group. Although stroke was relatively uncommon among cardiovascular events, it predicted unfavorable outcome in KTRs.
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spelling pubmed-63881052019-02-27 The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease Huang, Shih-Ting Yu, Tung-Min Chuang, Ya-Wen Chung, Mu-Chi Wang, Chen-Yu Fu, Pin-Kuei Ke, Tai-Yuan Li, Chi-Yuan Lin, Cheng-Li Wu, Ming-Ju Kao, Chia-Hung Int J Environ Res Public Health Article Background: The incidence of stroke after kidney transplantation is poorly understood. Our study aimed to determine the incidence and predictors of stroke as well as mortality from stroke in kidney transplant recipients (KTRs). Methods: This retrospective cohort study used the National Health Insurance Research Database in Taiwan to study KTRs (N = 4635), patients with end-stage renal disease (ESRD; N = 69,297), and patients from the general population who were chronic kidney disease (CKD)-free and matched by comorbidities (N = 69,297) for the years 2000 through 2010. The risk of stroke was analyzed using univariate and multivariate Cox regression models and compared between study cohorts. Findings: Compared with the ESRD subgroup, KTRs had a significantly lower risk of overall stroke (adjusted hazard ratio (aHR) = 0.37, 95% confidence interval (CI) = 0.31–0.44), ischemic stroke (aHR = 0.45, 95% CI = 0.37–0.55), and hemorrhagic stroke (aHR = 0.20, 95% CI = 0.14–0.29). The risk patterns for each type of stroke in the KTR group were not significantly different than those of the CKD-free control subgroup. The predictors of stroke were age and diabetes in KTRs. All forms of stroke after transplantation independently predicted an increased risk of subsequent mortality, and the strongest risk was related to hemorrhagic events. Interpretation: KTRs had a lower risk of stroke than ESRD patients, but this risk was not significantly different from that of the CKD-free comorbidities-matched general population group. Although stroke was relatively uncommon among cardiovascular events, it predicted unfavorable outcome in KTRs. MDPI 2019-01-24 2019-02 /pmc/articles/PMC6388105/ /pubmed/30682846 http://dx.doi.org/10.3390/ijerph16030326 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Huang, Shih-Ting
Yu, Tung-Min
Chuang, Ya-Wen
Chung, Mu-Chi
Wang, Chen-Yu
Fu, Pin-Kuei
Ke, Tai-Yuan
Li, Chi-Yuan
Lin, Cheng-Li
Wu, Ming-Ju
Kao, Chia-Hung
The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease
title The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease
title_full The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease
title_fullStr The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease
title_full_unstemmed The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease
title_short The Risk of Stroke in Kidney Transplant Recipients with End-Stage Kidney Disease
title_sort risk of stroke in kidney transplant recipients with end-stage kidney disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388105/
https://www.ncbi.nlm.nih.gov/pubmed/30682846
http://dx.doi.org/10.3390/ijerph16030326
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