From the Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia (N.L.D.L.M., P.J.K., A.C.W.).
Department of Renal Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom (P.M.).
Stroke. 2019 Feb;50(2):487-490. doi: 10.1161/STROKEAHA.118.023644.
Background and Purpose- People with end-stage kidney disease (ESKD) are at greater risk of stroke. We aimed to compare stroke mortality between the ESKD population and the general population. Methods- We included all patients with incident ESKD in Australia, 1980 to 2013, and New Zealand, 1988 to 2012. The primary cause of death was ascertained using data linkage with national death registers. We produced standardized mortality ratios for stroke deaths, by age, sex, and calendar year. Results- We included 60 823 patients with ESKD, where 941 stroke deaths occurred during 381 874 person-years. Patients with ESKD had >3× the stroke deaths compared with the general population (standardized mortality ratio, 3.4; 95% CI, 3.2-3.6), markedly higher in younger people and women. The greatest excess was in intracerebral hemorrhages (standardized mortality ratio, 5.2; 95% CI, 4.5-5.9). Excess stroke deaths in patients with ESKD decreased over time, although were still double in 2013 (2013 standardized mortality ratio, 2.1; 95% CI, 1.5-2.9). Conclusions- People with ESKD experience much greater stroke mortality with the greatest difference for women and younger people. However, mortality has improved over time.
背景和目的- 终末期肾病（ESKD）患者发生中风的风险更高。我们旨在比较 ESKD 人群和普通人群的中风死亡率。
方法- 我们纳入了澳大利亚 1980 年至 2013 年和新西兰 1988 年至 2012 年所有新发 ESKD 患者。通过与国家死亡登记处的数据链接确定主要死因。我们根据年龄、性别和日历年份，为中风死亡制作了标准化死亡率比。
结果- 我们纳入了 60823 名 ESKD 患者，其中 941 例中风死亡发生在 381874 人年中。与普通人群相比，ESKD 患者的中风死亡人数超过 3 倍（标准化死亡率比为 3.4；95%置信区间为 3.2-3.6），年轻人和女性更为明显。脑出血的超额死亡（标准化死亡率比为 5.2；95%置信区间为 4.5-5.9）最高。尽管 2013 年仍为两倍（2013 年标准化死亡率比为 2.1；95%置信区间为 1.5-2.9），但 ESKD 患者的中风死亡人数随着时间的推移呈下降趋势。
结论- ESKD 患者的中风死亡率更高，女性和年轻人的差异最大。然而，死亡率随着时间的推移有所改善。
