Chen Yuemei, Liu Hong, Zou Jianzhou, Ge Yuxing, Teng Jie, Xu ShaoWei, Lv WenLv, Liu Zhonghua, Xu Yan, Cao XueSen, Shen Bo, Ding XiaoQiang
Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Clin Neurol Neurosurg. 2013 May;115(5):557-61. doi: 10.1016/j.clineuro.2012.06.028. Epub 2012 Jul 13.
Residual renal function (RRF) recently has been confirmed to be a significant predictor of morbidity and mortality in hemodialysis (HD) patients. As RRF is not exactly the same with 24-h residual urine volume, the aim of our study is to evaluate the association of residual urine volume with acute ischemic stroke (AIS) among HD patients.
282 patients starting chronic HD in our center during January 2005 and December 2008 were enrolled. The clinical data at HD initiation and the occurrence of AIS since starting HD were recorded and obtained from our database. According to the prevalence of AIS, we divided 282 patients into the AIS group (n=69) and non-AIS (n=213) group.
A total of 69 (24.5%) patients suffered from AIS since HD initiation. Patients with AIS were much older, with more diabetes, had higher levels of hemoglobin, while lower levels of residual urine volume and serum uric acid. In multivariate logistic regression analysis, old age (OR, 1.036; 95% CI, 1.009-1.063; P=0.008), diabetes (OR, 2.385; 95% CI, 1.074-5.294; P=0.033) and 24-h residual urine volume<1290 ml at HD initiation (OR, 2.446; 95% CI, 1.219-4.907; P=0.012) was significant predictors for future AIS occurrence during HD.
This study indicates that residual urine volume levels at HD initiation are inversely associated with AIS risk in future in chronic HD patients. Besides, aging and diabetes should also be noticed for prevention of AIS.
残余肾功能（RRF）最近已被证实是血液透析（HD）患者发病率和死亡率的重要预测指标。由于RRF与24小时残余尿量并不完全相同，我们研究的目的是评估HD患者残余尿量与急性缺血性卒中（AIS）之间的关联。
纳入2005年1月至2008年12月在本中心开始慢性HD的282例患者。记录并从我们的数据库中获取HD开始时的临床数据以及开始HD后AIS的发生情况。根据AIS的患病率，我们将282例患者分为AIS组（n = 69）和非AIS组（n = 213）。
自HD开始以来，共有69例（24.5%）患者发生AIS。AIS患者年龄更大，糖尿病患者更多，血红蛋白水平更高，而残余尿量和血清尿酸水平更低。在多因素逻辑回归分析中，高龄（OR，1.036；95%CI，1.009 - 1.063；P = 0.008）、糖尿病（OR，2.385；95%CI，1.074 - 5.294；P = 0.033）以及HD开始时24小时残余尿量<1290 ml（OR，2.446；95%CI，1.219 - 4.907；P = 0.012）是HD期间未来发生AIS的显著预测因素。
本研究表明，慢性HD患者HD开始时的残余尿量水平与未来AIS风险呈负相关。此外，预防AIS还应注意衰老和糖尿病。
