Reduced risk of new onset stroke after kidney transplantation in Asian dialysis patients: a propensity score-matched, competing risk study in Taiwan

doi:10.1093/qjmed/hcz051

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標題:	Reduced risk of new onset stroke after kidney transplantation in Asian dialysis patients: a propensity score-matched, competing risk study in Taiwan
作者:	Weng, S. -F. Shen, Y. -C. Wang, J. -J. Kai-Jen Tien(田凱仁)
貢獻者:	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
關鍵字:	CEREBROVASCULAR EVENTS PLASMA HOMOCYSTEINE ISCHEMIC-STROKE DISEASE SUBDISTRIBUTION HEMODIALYSIS PHOSPHORUS MORBIDITY MORTALITY MODEL
日期:	2019-07
上傳時間:	2020-07-29 13:55:01 (UTC+8)
出版者:	OXFORD UNIV PRESS
摘要:	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.
關聯:	Qjm-An International Journal of Medicine, v.112, n.7, pp.489-495
顯示於類別:	[高齡福祉養生管理系] 期刊論文

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