Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/32680
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    Title: Reduced risk of new onset stroke after kidney transplantation in Asian dialysis patients: a propensity score-matched, competing risk study in Taiwan
    Authors: Weng, S. -F.
    Shen, Y. -C.
    Wang, J. -J.
    Kai-Jen Tien(田凱仁)
    Contributors: Kaohsiung Med Univ, Dept Healthcare Adm & Med Informat, Coll Hlth Sci
    Kaohsiung Med Univ Hosp, Dept Med Res
    Kaohsiung Chang Gung Mem Hosp, Dept Urol
    Cheng Shiu Univ, Ctr Gen Educ
    Chi Mei Med Ctr, Dept Med Res
    Southern Taiwan Univ Sci & Technol, Allied AI Biomed Ctr
    Chi Mei Med Ctr, Div Endocrinol & Metab, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management
    Keywords: CEREBROVASCULAR EVENTS
    PLASMA HOMOCYSTEINE
    ISCHEMIC-STROKE
    DISEASE
    SUBDISTRIBUTION
    HEMODIALYSIS
    PHOSPHORUS
    MORBIDITY
    MORTALITY
    MODEL
    Date: 2019-07
    Issue Date: 2020-07-29 13:55:01 (UTC+8)
    Publisher: OXFORD UNIV PRESS
    Abstract: Background: Kidney transplantation (KT) has been found to reduce cardiovascular events and mortality in chronic dialysis patients. There is little data, however, regarding the risk reduction of cerebrovascular events after KT in Asian populations. This study evaluates the risk of cerebrovascular events after KT in Taiwan. Methods: Tapping Taiwan's National Health Insurance claims data of patients with a diagnosis of end-stage renal disease (ESRD), we enrolled all KT recipients from 1999 to 2011 (n = 2908). For each KT patient, four controls (patients also diagnosed with ESRD) without KT were propensity matched by birth date, sex, selected comorbidities and duration of dialysis. All subjects were followed to the end of 2011. Results: The incidence rate for stroke in the KT recipients and comparison group were 52.63 and 137.26 per 10 000 person-years, respectively. After adjustment for age, gender and comorbidities with competing mortality, KT recipients had 60% reduction in all kinds of stroke, compared to those who did not receive procedure. They were found to have a 48 and 74% reduction in ischemic and hemorrhagic stroke risk, respectively. Subgroup analyses also showed similar trends in the improvement of stroke after KT. While elderly patients, men, and those with diabetes, hypertension and coronary artery disease are at increased risk for stroke, our log-rank test revealed those that received KT had significantly lower cumulative incidence rates of stroke than those that did not (P < 0.001). Conclusions: KT was associated with reduced risk of new onset stroke in chronic dialysis patients in Taiwan.
    Relation: Qjm-An International Journal of Medicine, v.112, n.7, pp.489-495
    Appears in Collections:[Dept. of Senior Service and Health Management] Periodical Articles

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