Young stroke patients are at high risk for subsequent end-stage renal disease: a population-based observational study

Background. An increased incidence of end-stage renal disease (ESRD) in stroke patients has not been confirmed. The aim of this population-based study was to examine the risk of ESRD in stroke patients in Taiwan. Methods. We conducted a nationwide cohort study of 442 355 patients newly diagnosed with stroke, but without prior history of ESRD. Data were collected from Taiwan's National Health Insurance claims data during 2000-2008. Incidence and standardized incidence ratio (SIR) of ESRD were calculated using the general population of Taiwan as the reference. Results. Among all stroke patients, 7813 (1.77%) developed ESRD with a mean follow-up of 4.11 years. The SIR for ESRD was 2.78 [95% confidence interval (CI): 2.72-2.84] among stroke patients of all ages and was 22.73 (95% CI: 20.39-25.20) for patients aged 25-44 years. Male patients with stroke had a higher risk of ESRD (SIR: 2.94, 95% CI: 2.85-3.03) among stroke patients of all ages, and it was 23.41 (95% CI: 20.46-26.36) for male patients aged 25-44 years. Conclusions. Increased risk of ESRD in stroke patients is confirmed in Taiwan, and male patients between ages 25 and 44 years were at higher risk of ESRD compared with their counterparts in the general population. The clinical implication of our results is to closely monitor renal function in stroke patients, particularly those of younger age.