| [ Summary ] |
Chronic kidney disease (CKD) is a risk factor for strokes. As renal function decreases, stroke risk increases. Therefore, hemodialysis patients are at very high risk of stroke. In the past, the percentages of cerebral infarction and subarachnoid hemorrhage were lower and those for cerebral bleeding was in patients with than without hemodialysis. In recent years, however, cases of cerebral bleeding have declined and the number of cerebral infarctions has increased. For stroke prevention in dialysis patients, life style modification including smoking cessation, salt intake limitation, reducing body weight, and avoiding excess alcohol consumption, as well as strict management of blood pressure is recommended. Target blood pressure should be below 130 / 80 mmHg. Strict management of blood glucose and hemoglobin A1c levels is also recommended in diabetic patients. Since dialysis patients are at high risk of cerebral hemorrhage, decision making for indications of antithrombotic and thrombolytic therapies should be very caucious. |