Stroke and its correlates among patients on maintenance hemodialysis in Cameroon.

Autor: Teuwafeu DG; Buea Regional Hospital, Buea, Cameroon.; Faculty of Health Sciences, University of Buea, Cameroon., Halle MP; Douala General Hospital, Douala, Cameroon.; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon., Kenfack NA; Faculty of Health Sciences, University of Buea, Cameroon., Nkouonlack CD; Buea Regional Hospital, Buea, Cameroon.; Faculty of Health Sciences, University of Buea, Cameroon., Fouda H; Douala General Hospital, Douala, Cameroon.; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon., Nkoke C; Buea Regional Hospital, Buea, Cameroon., Mapoure Njankouo Y; Douala General Hospital, Douala, Cameroon.; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
Jazyk: angličtina
Zdroj: Hemodialysis international. International Symposium on Home Hemodialysis [Hemodial Int] 2023 Oct; Vol. 27 (4), pp. 419-427. Date of Electronic Publication: 2023 Jun 01.
DOI: 10.1111/hdi.13097
Abstrakt: Background: End-stage kidney disease is an independent risk factor for stroke; however, the relationship between hemodialysis and stroke in Sub-Saharan Africa has not been established.
Objective: To evaluate the incidence, associated factors, and clinical outcome of stroke among patients undergoing maintenance hemodialysis in Cameroon.
Methods: A hospital-based retrospective study using data from the medical files of 1060 patients on maintenance hemodialysis (given twice a week) was conducted. Patients with stroke prior to starting hemodialysis were excluded. Socio-demographic data, comorbidities, dialysis parameters, and data concerning the diagnosis of stroke were retrieved and analyzed.
Results: The dialysis vintage (duration of time on dialysis) averaged 11.4 ± 9.2 months. The incidence of stroke was 6.1 events per 1000 patient-years, with hemorrhagic stroke being most common (66%). Eighty percent of strokes occurred before the 30th month of dialysis. Sixty percent of strokes occurred within 24 h of a dialysis session. Predictive factors for stroke were diabetes mellitus (p = 0.026), heart failure (p = 0.045), poor dialysis compliance (p = 0.001), and short vintage (p = 0.001). The overall mortality rate was 52% and was higher for hemorrhagic stroke (60%). The leading causes of death were multiple organ failure and sepsis.
Conclusion: The incidence of stroke is high among hemodialysis patients in Cameroon and hemorrhagic stroke is the commonest type. Diabetes and heart failure triple the risk of stroke. Mortality in patients who suffered a stroke was high.
(© 2023 International Society for Hemodialysis.)
Databáze: MEDLINE
Externí odkaz: