Buea Regional Hospital, Buea, Cameroon.
Faculty of Health Sciences, University of Buea, Cameroon.
Hemodial Int. 2023 Oct;27(4):419-427. doi: 10.1111/hdi.13097. Epub 2023 Jun 1.
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.
To evaluate the incidence, associated factors, and clinical outcome of stroke among patients undergoing maintenance hemodialysis in Cameroon.
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.
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.
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.
终末期肾病是中风的独立危险因素；然而，在撒哈拉以南非洲，血液透析与中风之间的关系尚未确定。
评估喀麦隆维持性血液透析患者中风的发生率、相关因素和临床结局。
采用回顾性医院研究，使用 1060 名维持性血液透析（每周两次）患者的病历数据。排除在开始血液透析前患有中风的患者。检索并分析了社会人口统计学数据、合并症、透析参数以及中风诊断数据。
透析龄（开始透析的时间）平均为 11.4±9.2 个月。中风发生率为每 1000 患者年 6.1 例，其中出血性中风最常见（66%）。80%的中风发生在透析的第 30 个月之前。60%的中风发生在透析治疗后 24 小时内。中风的预测因素包括糖尿病（p=0.026）、心力衰竭（p=0.045）、透析不依从（p=0.001）和透析龄短（p=0.001）。总死亡率为 52%，出血性中风的死亡率更高（60%）。死亡的主要原因是多器官衰竭和败血症。
喀麦隆血液透析患者中风的发生率较高，出血性中风是最常见的类型。糖尿病和心力衰竭使中风的风险增加三倍。中风患者的死亡率较高。
