Ischemic Stroke in Patients with Renal Transplantation.
- Author:
Tae Jin SONG
1
;
Myoung Jin CHA
;
Jinkwon KIM
;
Dong Hyun LEE
;
Hye Sun LEE
;
Chung Mo NAM
;
Young Dae KIM
;
Hyo Suk NAM
;
Ji Hoe HEO
Author Information
1. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. jhheo@yuhs.ac
- Publication Type:Original Article
- Keywords:
Renal transplantation;
End stage renal disease;
Stroke;
Cerebral infarction;
Cerebral microbleeds;
Leukoaraiosis
- MeSH:
Brain;
Cerebral Infarction;
Chondroitin Sulfates;
Dermatan Sulfate;
Dialysis;
Glycosaminoglycans;
Heparitin Sulfate;
Hospital Mortality;
Humans;
Kidney Failure, Chronic;
Kidney Transplantation;
Leukoaraiosis;
Multivariate Analysis;
National Institutes of Health (U.S.);
Stroke
- From:Korean Journal of Stroke
2012;14(3):122-127
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Impaired renal function may contribute to development of stroke and small vessel pathology in the brain. We investigated whether stroke subtype, initial stroke severity, early neurologic outcomes, time to cerebral infarction occurrence, and the presence of small vessel pathology in the brain are different between patients with end stage renal disease (ESRD) and those with renal transplantation (RT). METHODS: A total of 57 consecutive de novo RT patients (RT group) and 120 patients undergoing dialysis due to ESRD (ESRD group) who developed a first-ever acute cerebral infarction were enrolled. We compared stroke subtypes based on the Trial of Org 10172 in Acute Stroke Treatment classification, the presence of small vessel pathology (cerebral microbleed, leukoaraiosis and silent lacunar infarction) on MRI, stroke severity based on the National Institutes of Health Stroke Scale (NIHSS) and in-hospital mortality between the groups. RESULTS: The stroke subtypes, NIHSS scores at admission and in-hospital mortality were not different between the two groups. On multivariate analysis, the presence of high grade periventricular white matter changes tended to be more frequently detected in the ESRD group than the RT (P=0.078). The time from starting dialysis to stroke was longer in the RT group (129.9+/-60.9 months) than in the ESRD group (51.1+/-46.1 months). CONCLUSIONS: The stroke patterns, severity and short term outcomes were not different between RT and ESRD. The risk of cerebral infarction and high grade periventricular white matter changes may be reduced after RT in patients with ESRD.
