24-h residual urine volume at hemodialysis initiation: a possible predictor for acute ischemic stroke incurrence in hemodialysis patients.
BACKGROUND
Residual renal function (RRF) recently has been confirmed to be a significant predictor of morbidity and mortality in hemodialysis (HD) patients. As RRF is not exactly the same with 24-h residual urine volume, the aim of our study is to evaluate the association of residual urine volume with acute ischemic stroke (AIS) among HD patients.


METHODS
282 patients starting chronic HD in our center during January 2005 and December 2008 were enrolled. The clinical data at HD initiation and the occurrence of AIS since starting HD were recorded and obtained from our database. According to the prevalence of AIS, we divided 282 patients into the AIS group (n=69) and non-AIS (n=213) group.


RESULTS
A total of 69 (24.5%) patients suffered from AIS since HD initiation. Patients with AIS were much older, with more diabetes, had higher levels of hemoglobin, while lower levels of residual urine volume and serum uric acid. In multivariate logistic regression analysis, old age (OR, 1.036; 95% CI, 1.009-1.063; P=0.008), diabetes (OR, 2.385; 95% CI, 1.074-5.294; P=0.033) and 24-h residual urine volume<1290 ml at HD initiation (OR, 2.446; 95% CI, 1.219-4.907; P=0.012) was significant predictors for future AIS occurrence during HD.


CONCLUSIONS
This study indicates that residual urine volume levels at HD initiation are inversely associated with AIS risk in future in chronic HD patients. Besides, aging and diabetes should also be noticed for prevention of AIS.
Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Yuemei
Y
Chen
Hong
H
Liu
Jianzhou
J
Zou
Yuxing
Y
Ge
Jie
J
Teng
ShaoWei
S
Xu
WenLv
W
Lv
Zhonghua
Z
Liu
Yan
Y
Xu
XueSen
X
Cao
Bo
B
Shen
XiaoQiang
X
Ding
D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology*; D002544:Cerebral Infarction / Q000453:epidemiology / Q000209:etiology; D003627:Data Interpretation, Statistical; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D007677:Kidney Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D014527:Uric Acid / Q000097:blood; D014556:Urine / Q000502:physiology*
D006454:Hemoglobins; D014527:Uric Acid