Korean J Stroke.  2012 Dec;14(3):122-127.

Ischemic Stroke in Patients with Renal Transplantation

• Song TJ
• Cha MJ
• Kim J
• Lee DH
• Lee HS
• Nam CM
• Kim YD
• Nam HS
• Heo JH

Abstract

BACKGROUND
Impaired renal function may contribute to development of stroke and small vessel pathology in the brain. We investigated whether stroke subtype, initial stroke severity, early neurologic outcomes, time to cerebral infarction occurrence, and the presence of small vessel pathology in the brain are different between patients with end stage renal disease (ESRD) and those with renal transplantation (RT).
METHODS
A total of 57 consecutive de novo RT patients (RT group) and 120 patients undergoing dialysis due to ESRD (ESRD group) who developed a first-ever acute cerebral infarction were enrolled. We compared stroke subtypes based on the Trial of Org 10172 in Acute Stroke Treatment classification, the presence of small vessel pathology (cerebral microbleed, leukoaraiosis and silent lacunar infarction) on MRI, stroke severity based on the National Institutes of Health Stroke Scale (NIHSS) and in-hospital mortality between the groups.
RESULTS
The stroke subtypes, NIHSS scores at admission and in-hospital mortality were not different between the two groups. On multivariate analysis, the presence of high grade periventricular white matter changes tended to be more frequently detected in the ESRD group than the RT (P=0.078). The time from starting dialysis to stroke was longer in the RT group (129.9+/-60.9 months) than in the ESRD group (51.1+/-46.1 months).
CONCLUSIONS
The stroke patterns, severity and short term outcomes were not different between RT and ESRD. The risk of cerebral infarction and high grade periventricular white matter changes may be reduced after RT in patients with ESRD.

Keyword

Renal transplantation; End stage renal disease; Stroke; Cerebral infarction; Cerebral microbleeds; Leukoaraiosis

MeSH Terms

Brain
Cerebral Infarction
Chondroitin Sulfates
Dermatan Sulfate
Dialysis
Glycosaminoglycans
Heparitin Sulfate
Hospital Mortality
Humans
Kidney Failure, Chronic
Kidney Transplantation
Leukoaraiosis
Multivariate Analysis
National Institutes of Health (U.S.)
Stroke
Chondroitin Sulfates
Dermatan Sulfate
Glycosaminoglycans
Heparitin Sulfate