Evidence for high incidence of end-stage renal disease in patients after stroke and acute myocardial infarction at age 60 or younger

The impact of stroke and acute myocardial infarction (AMI) on the incidence of end-stage renal disease (ESRD) is unknown. Two community-based registri es, one of patients with stroke or AMI and another of patients with ESRD wh o undergo dialysis, are available in Okinawa, Japan. Whether survivors afte r stroke and AMI who were registered from April 1988 through March 1991 ent ered an ESRD dialysis program by the end of December 1999 was determined. A mong 4,556 patients (3,809 patients with stroke, 747 patients with AMI) who survived at least 28 days after the event onset, 44 patients (36 patients, stroke, 8 patients, AMI) entered an ESRD dialysis program during the study period. The 10-year cumulative incidence of ESRD was approximately 2.0% in those who survived stroke or AMI. The observed-expected ratio was 4.1 in m en (P < 0.01) and 5.8 in women (P < 0.01) aged 30 to 59 years and 0.8 in me n (not significant) and 0.4 in women (not significant) 60 years and older. The present results confirm that survivors after stroke or AMI have a great er incidence of ESRD than those in the general population, in particular, t hose who had stroke or AMI at 60 years or younger. (C) 2001 by the National Kidney Foundation, Inc.