石塚 健太郎
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Characteristics and Prognosis of Stroke in Living Donor Renal Transplant Recipients.
Journal Formal name:Journal of atherosclerosis and thrombosis
Abbreviation:J Atheroscler Thromb
ISSN code:18803873/13403478
Domestic / ForeginForegin
Volume, Issue, Page pp.in press
Author and coauthor Mizuno Takafumi†, Hoshino Takao*, Ishizuka Kentaro, Toi Sono, Nishimura Ayako, Takahashi Shuntaro, Wako Sho, Kitagawa Kazuo
Publication date 2021/11
Summary AIMS:We aimed to determine the characteristics and vascular outcomes of stroke in renal transplant (RT) recipients and compare them with those in patients on hemodialysis (HD) and those with no renal replacement therapy (RRT).METHODS:In this prospective observational study, 717 patients (mean age, 70.8 years; male, 60.5%) with acute ischemic stroke within one week of onset were consecutively enrolled and followed for one year. The patients were classified into three groups: (1) living donor RT recipients (n=27); (2) patients on maintenance HD before the index stroke (n=39); and (3) those with no history of RRT (n=651). The primary outcome was a composite of major adverse cardiovascular events (MACE).RESULTS:Diabetic nephropathy was the most common reason for RRT in both RT and HD patients. RT patients were more likely to have embolic stroke of undetermined source (33.3%) than others, whereas HD patients more often had cardioembolism (51.3%). No difference was observed in the MACE risk between the patients in RT and non-RRT groups (annual rate, 11.3% vs. 13.1%; log-rank P=0.82; hazard ratio [95% confidence interval], 0.92 [0.29-2.98]). In contrast, HD patients had a greater risk of MACE than those with no RRT (annual rate, 28.2% vs. 13.1%; log-rank P=0.019; hazard ratio [95% confidence interval], 2.24 [1.16-4.3]).CONCLUSIONS:The underlying etiologies of stroke differed in RT and HD patients. The one-year risk of MACE for stroke patients who had received an RT was lower than that for patients undergoing HD and comparable with that of patients with no RRT.
DOI 10.5551/jat.63189
PMID 34776472