title: Incidence, etiology, and outcome of stroke in patients on continuous ambulatory peritoneal dialysis.
abstract: BACKGROUND
  Little information exists on clinical features of stroke in patients receiving continuous ambulatory peritoneal dialysis (CAPD). The goals of this study was to clarify features of stroke in CAPD patients, to determine factors to predict onset of stroke during chronic CAPD, and to determine whether CAPD had an advantage over hemodialysis (HD) for prevention of stroke.
  
  
  METHODS
  We determined features of stroke in 12 patients (14 attacks including 7 parenchymal and 1 subarachnoid hemorrhage and 6 infarction) among 188 consecutive patients on CAPD, and compared them with those of 137 stroke patients among 1,681 consecutive patients on hemodialysis.
  
  
  RESULTS
  Incidence of stroke for CAPD patients (15.7 per 1,000 person-years) was high compared with that of HD patients (approximately 12) or general residents in our suburban town. Patients with stroke on CAPD were younger than those on HD (52 +/- 12 vs. 62 +/- 11 years, p = 0.008). Mean arterial pressure (MAP) of patients with stroke increased after the introduction of CAPD (p = 0.01), whereas that of patients without stroke did not change. Increase in MAP during chronic CAPD was related independently to the occurrence of total stroke or brain hemorrhage. The majority of CAPD patients with stroke (67%) were dead or dependent in the chronic stage of stroke.
  
  
  CONCLUSIONS
  CAPD patients seem to have a greater risk of stroke than the general population primarily because of poor control of hypertension, presumably in part due to overhydration. CAPD does not seem to have an advantage over HD for the prevention of stroke.
authors.affiliation: Stroke Center, Fukuoka Red Cross Hospital, Japan. toyoda@qmed.hosp.go.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Fujii
authors.forename: Takashi
authors.initials: T
authors.lastname: Ando
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kumai
authors.forename: Setsuro
authors.initials: S
authors.lastname: Ibayashi
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*; D016896:Treatment Outcome