PREDICTORS OF STROKE IN PATIENTS RECEIVING CHRONIC-HEMODIALYSIS

To identify the risk factors of stroke in patients receiving maintenan ce hemodialysis, we conducted a prospective study on patients in Okina wa, Japan. Patients with end-stage renal disease who were treated with maintenance hemodialysis before the end of 1990 and were alive on Jan uary 1, 1991 (N = 1,243) were studied. Medical records and pertinent d ata as of January 1, 1991 were compiled. All occurrences of stroke wer e recorded throughout the follow-up period, and until the end of 1995. The duration of observation was 5,110.3 patient-years. A total of 90 cases of stroke were observed, including 63 (70.0%) cerebral hemorrhag e, 20 (22.2%) cerebral infarction, and 7 (7.8%) subarachnoid hemorrhag e. Multiple logistic analysis identified hypertension as an independen t predictor of stroke, with an odds ratio of 2.38 and a 95% confidence interval from 1.26 to 4.50. The present study demonstrates that the h igh incidence of stroke is at least partially explained by insufficien t control of hypertension. Every effort to control hypertension is war ranted in chronic dialysis patients.