Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug 30;18(1):277.
doi: 10.1186/s12882-017-0697-0.

Reverse epidemiology of elevated blood pressure among chronic hemodialysis black patients with stroke: a historical cohort study

Yannick Nlandu  1 , François Lepira  2 , Jean-Robert Makulo  2 , Yannick Engole  2 , Ernest Sumaili  2 , Marie-Noelle Wameso  2 , Vieux Mokoli  2 , Jeannine Luse  3 , Augustin Longo  2 , Chantal Zinga  2 , Pierre Akilimali  4 , Aliocha Nkodila  2 , Mélanie Bavassa  5 , François Kajingulu  2 , Justine Bukabau  2 , Nazaire Nseka  2
Affiliations

Reverse epidemiology of elevated blood pressure among chronic hemodialysis black patients with stroke: a historical cohort study

Yannick Nlandu et al. BMC Nephrol. .

Abstract

Background: Stroke is the third leading cause of cardiovascular mortality in dialysis patients. The objective of this study was to assess the extent of stroke in chronic hemodialysis patients.

Methods: Historical cohort of patients enrolled in two hemodialysis (HD) centers from January 1, 2010 to December 31, 2011, including 191 patients (mean age 52 years, 68% men). Incidence curves and survival time analysis between the first day of HD and the end of the study were described by the Kaplan-Meier method. Independent stroke predictors were identified by multiple logistic regression analysis. P < 0.05 defined the level of statistical significance.

Results: 12 incident stroke were recorded during the study period, with 1622.1 person-months (PM), a stroke incidence rate of 7.4 cases per 1000 PM (95% CI = 7.35-7.44) at the point date. The incidence of stroke at 6 months, 12 months and 24 months was 9.8%, 11.9% and 13%, respectively. Only the absence of arterial hypertension (RR = 5.7, 95% CI: 1.52-21.42) emerged as an independent determinant of stroke.

Conclusion: The high incidence of stroke in Kinshasa HD centers is partially explained by reverse epidemiology. Efforts must be made to understand this phenomenon in order to reduce its impact.

Keywords: Black people; Hemodialysis; Incidence; Reverse epidemiology; Stroke.

PubMed Disclaimer

Conflict of interest statement

Competing interest

The authors declare that they do not have any financial interest with the information contained in this paper.

Ethics approval and consent to participate

The study protocol was approved by the Clinical Research Ethics Committee of Public Health’s School (Kinshasa, DRC), number ESP/CE/019/2016. This is a retrospective study and written informed consent was not required.

Consent for publication

Not applicable.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
cumulative incidence of stroke curve calculated by Kaplan –Meier method
Fig. 2
Fig. 2
Cumulative incidence of stroke curve in HTA and non HTA group by Kaplan-Meier method
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Fu J, Huang J, Lei M, Luo Z, Zhong X, Huang Y, et al. Prevalence and Impact on Stroke in Patients Receiving Maintenance Hemodialysis versus Peritoneal Dialysis: A Prospective Observational Study. PLos ONE 10(10):e0140887. doi:10.1371/Journal.pone.0140887. - PMC - PubMed
    1. Iseki K, Fukiyama K. Predictors of stroke in patients receiving chronic hemodialysis. Kidney Int. 1996;50:1672–1675. doi: 10.1038/ki.1996.484. - DOI - PubMed
    1. Sozio S, Amstrong P, Coresh J, Jaar B, Fink N, Plantinga L, et al. Cerebrovascular disease incidence, characteristics, and outcomes in patients initiating dialysis: the choices for healthy outcomes in caring for ESRD (CHOICE)study. AJKD. 2009;54:468–477. doi: 10.1053/j.ajkd.2009.01.261. - DOI - PMC - PubMed
    1. Power A. Stroke in dialysis and chronic kidney. Blood Purif. 2013;36:179–183. doi: 10.1159/000356086. - DOI - PubMed
    1. Herrington W, Haynes R, Staplin N, Emberson J, Baigent C, Landray M. Evidence for the prevention and treatment of stroke in dialysis patients. Semin Dial. 2015;28:35–47. doi: 10.1111/sdi.12281. - DOI - PMC - PubMed