title: Risk of Stroke in Patients with ESRD.
abstract: OBJECTIVE
  This study aimed to determine absolute and excess stroke risks in people with ESRD compared with the general population.
  
  
  METHODS
  This cohort study used data linkage between the Australia and New Zealand Dialysis and Transplant Registry and hospital and death records for 10,745 people with ESRD in New South Wales from 2000 to 2010. For the general population, Australian Institute of Health and Welfare hospital usage records and Australian Bureau of Statistics census data were used. Rates and standardized incidence rate ratios of hospitalization with a stroke were calculated.
  
  
  RESULTS
  People with ESRD had 640 hospitalizations with stroke in 49,472 person-years of follow-up (1294 per 100,000 person-years), and people in the general population had 338,392 hospitalizations with stroke (212 per 100,000 person-years), an incidence rate ratio of 3.32 (95% confidence interval, 3.31 to 3.33). Excess risk was greater for women (incidence rate ratio, 5.14; 95% confidence interval, 5.11 to 5.18) than men (incidence rate ratio, 2.52; 95% confidence interval, 2.51 to 2.54; P for interaction <0.001) and decreased with age. People ages 35-39 years old with ESRD had an 11 times increased risk of stroke (incidence rate ratio, 11.08; 95% confidence interval, 9.41 to 13.05), and risk in people ages ≥85 years old increased 2-fold (incidence rate ratio, 2.04; 95% confidence interval, 1.87 to 2.23; P for interaction <0.001). Excess risk was greater for intracerebral hemorrhage (incidence rate ratio, 4.18; 95% confidence interval, 4.11 to 4.26) than ischemic stroke (incidence rate ratio, 3.43; 95% confidence interval, 3.40 to 3.45; P for interaction <0.01).
  
  
  CONCLUSIONS
  People with ESRD have a substantially higher risk of stroke, particularly women and young people, and hemorrhagic stroke. Future work could investigate effective and safe interventions for primary and secondary prevention of stroke in people with ESRD.
authors.affiliation: Sydney School of Public Health and Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia; and philip.masson@sydney.edu.au.
authors.forename: Philip
authors.initials: P
authors.lastname: Masson
authors.affiliation: Sydney School of Public Health and.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Kelly
authors.affiliation: Sydney School of Public Health and Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia; and.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia;
authors.forename: Richard I
authors.initials: RI
authors.lastname: Lindley
authors.affiliation: Sydney School of Public Health and Centre for Kidney Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia; and Centre for Renal and Transplant Research, Westmead Hospital, Westmead, New South Wales, Australia.
authors.forename: Angela C
authors.initials: AC
authors.lastname: Webster
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000453:epidemiology
keywords: cardiovascular disease; chronic dialysis; clinical epidemiology