Abstract: SA-PO894
Cannabis Use and Its Association with Incidence of Ischemic Stroke in Advanced CKD Patients Transitioning to ESRD
Session Information
- CKD: Pharmacoepidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Potukuchi, Praveen Kumar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Sumida, Keiichi, University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Gaipov, Abduzhappar, National Scientific Medical Center, Astana, Kazakhstan
- Park, Frank, University of Tennessee Health Sciences Center, Memphis, Tennessee, United States
- Kaplan, Cameron M., University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Moradi, Hamid, University of California, Irvine, Orange, California, United States
- Thomas, Fridtjof, University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Gatwood, Justin, University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Dashputre, Ankur A., University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Obi, Yoshitsugu, University of California Irvine, Irvine, California, United States
- Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
- Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
Background
The risk of stroke is especially high in patients with CKD/ESRD. The effects of cannabis use on incidence of stroke in patients with advanced CKD are unclear.
Methods
We examined 3,615 US veterans who transitioned to dialysis during 2007-2014 and had undergone urine toxicology tests up to one year prior to dialysis. We compared patients whose toxicology tests were positive for cannabis alone (N=202) with those whose tests were negative for all drugs (N=3,413). We examined the association of cannabis use with incident ischemic strokes (defined using ICD-9-CM codes) using Cox proportional hazards model adjusted for sociodemographics, comorbidities, medications, vital signs and time dependent dialysis initiation. We applied conditional repeated measures in Cox regression (modeling the full time-course of the recurrent events) to handle the occurrence of multiple strokes in the same patient.
Results
The mean (SD) age of the cohort was 61.4 (10.3) years; 97% were male, 41% were African American, and 73% had diabetes. Ischemic stroke occurred in 18% of the cohort (N=661) with a median (IQR) follow up time of 2 (1-4) years (one stroke event N=311 and ≥ 2 stroke events N=350). Cannabis use was associated with lower risk of stroke in unadjusted analysis [Figure]. However, the protective effect of cannabis use was attenuated in multivariable adjusted models [hazard ratio (95%CI): 0.88 (0.68-1.13)].
Conclusion
Cannabis use in advanced CKD patients is not significantly associated with the incidence of ischemic strokes.
Funding
- NIDDK Support