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Kidney Week

Abstract: FR-PO421

Outcome of Hemorrhagic Stroke in Patients on Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Author

  • Kumar, Alok, SGRR Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
Background

Patients on maintenance hemodialysis (MHD) on greater risk of hemorrhagic stroke or ischemic stroke. There is paucity of literature on outcome of hemorrhagic stroke (HS) in patients on MHD. Hypertension (HTN) and use of heparin during dialysis could be risk factors. We performed this study to identify risk factors associated with hemorrhagic stroke in patients on maintenance hemodialysis and outcome of such patients.

Methods

This study is a retrospective analysis of patients admitted with acute hemorrhagic stroke on MHD at our center. Study population comprised of 28 patients of hemorrhagic stroke with intracerebral hemorrhage. Study duration was from January 2008 to December 2018. All patients were on MHD for > 3 months. Hemorrhagic stroke was diagnosed with clinical examination and CT scan. Their demographic data , relevant investigations and clinical parameters were recorded. Student t test was used to compare data between survivors and non survivors.

Results

We had 28 patients ( 15 males and 13 females). Mean age of patients was 51.4+ 16 .5 years. Comorbidities were Hypertension (100%) , diabetes( 12 of 28),CAD ( 9 of 28), hyperlipidemia( 8of 28) and history of cerebrovascular accidents (5 of 28). Duration of HD was 27+ 9.2 months. All patients had severe hypertension at presentation ( BP > 200/110). Mean GCS at presentation was 9.8+ 4.1. Site of intracerebral hemorrhage ( ICH) was putamen ( 11 of 28), Thalamus ( 7 of 28), brain stem ( 4 of 28), massive ( 3 of 28) and others ( 3 of 28). Mortality was 68%(19 of 28). Mean time to death was 9.2+ 5.2 days. Neurological deterioration was cause of mortality. GCS at presentation and serum albumin were factors influencing survival . GCS was 13.8+ 3.7 in survivors and 4.7+ 1.9 in non survivors. S. albumin was 3.8 ± .4 gm% in survivors and 2.7±.5 gm% in non survivors.

Conclusion

Patients of hemorrhagic stroke on hemodialysis had dismal outcome with mortality of 68% and survivors had better GCS and s. albumin at presentation.