Stroke feature and management in dialysis patients.

Stroke feature and management in dialysis patients. Contrib Nephrol. 2013;179:100-9 Authors: Iseki K Abstract Strokes remain the major complication among dialysis population as the number of diabetes and elderly is increasing. In chronic hemodialysis patients, prevalence and incidence of stroke is higher than that of the general population. According to the annual registry data of the Japanese Society for Dialysis Therapy, prevalence of stroke death has been declining, yet the incidence of nonfatal incidence of stroke is not known. Underlying mechanisms of stroke are multiple. Among them, control of hypertension is important for the primary prevention; however, the ideal target level of blood pressure is not determined. Other than hypertension, maintaining good nutritional status is utmost important. Most observational studies suggested that the target was 140/90 mm Hg at prehemodialysis session. However, blood pressure levels are variable in both at office (before and after dialysis session) and at home. It is advisable to measure blood pressure multiple occasions and also at home. In case of acute cerebral hemorrhage, glycerol is indicated to prevent cerebral edema. Blood pressure is recommended to control as systolic <180 mm Hg or mean arterial pressure <130 mm Hg, and lower blood pressure gradually to 80% of the baseline level. In case of acute cerebral infarction hypertension is not treated unless severely hypertensive, systolic >...
Source: Contributions to Nephrology - Category: Urology & Nephrology Authors: Tags: Contrib Nephrol Source Type: research