期刊
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
卷 30, 期 5, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105686
关键词
End stage renal disease?Hemodialysis?Cerebral hemorrhage? Perihemorrhagic edema?Intracerebral hemorrhage
资金
- Shanghai Municipal Health and Health Commission [201940452]
The study found that maintenance hemodialysis has certain effects on hematoma and edema in patients with comorbid ESRD and ICH, reducing edema volume shortly after onset. However, the dialysis group had a higher in-hospital mortality rate. Nevertheless, there were no significant differences in 1-year mortality rate and functional neurologic scales between the dialysis and non-dialysis groups at the 1-year follow-up.
Objectives: End-stage renal disease (ESRD) is one of the most critical risk factors of intracerebral hemorrhage (ICH). We aimed to investigate the effects of maintenance hemodialysis on hematoma volume, edema volume, and prognosis in patients with comorbid ESRD and ICH. Materials and Methods: Patients with comorbid ESRD and ICH were divided into two groups based on whether receiving maintenance hemodialysis. Hematoma and perihemorrhagic edema (PHE) volumes and relative edema ratio after admission were assessed on head computed tomography scans. Results: During the initial diagnosis, the dialysis group had lower PHE volume (16.41 vs 35.90 mL, P = 0.010), total volume of hematoma and edema (31.58 vs 54.58 mL, P = 0.013), and relative edema ratio (0.57 vs 0.92, P = 0.033) than the non dialysis group. In addition, the peak PHE volume (36.68 vs 84.30 mL, P < 0.001), peak total volume of hematoma and edema (53.45 vs 127.69 mL, P = 0.011), and peak relative edema ratio (1.12 vs 1.92, P = 0.001) within one week after onset were lower in the dialysis group than in the non-dialysis group. The dialysis group had a higher in-hospital mortality rate than the non-dialysis group (40% vs 10%, P = 0.007). At 1-year follow-up, the two groups had similar 1-year-mortality rates and modified Rankin Scale. Conclusions: Hemodialysis can prevent the enlargement of edema and reduce PHE volume shortly after onset. Although dialyzed patients had a higher in-hospital mortality rate, hemodialysis did not affect 1-year survival rate and functional neurologic scales.
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