Ischemic stroke in patients with renal transplantation

Abstract

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) receiving dialysis treatment (DT) and those with renal transplantation (RT). From January 1995 to January 2011, a total of 57 consecutive RT patients (RT group) and 120 patients undergoing dialysis treatment due to ESRD (DT group) who developed a first-ever acute cerebral infarction were enrolled. We compared stroke subtypes, presence of small vessel pathology on MRI, stroke severity based on the National Institutes of Health Stroke Scale (NIHSS) and in-hospital mortality between the groups. 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 DT group than the RT group (p=0.078). The stroke patterns, severity and short term outcomes were not different between RT and DT groups. The risk of cerebral infarction and high grade periventricular white matter changes may be reduced after RT in patients with ESRD.