Abstract: 【Abstract】Objective Hemorrhagic stroke (HS) is a severe complication causing death and disability in maintenance dialysis patients. This study retrospectively investigated the incidence of HS, 30-day mortality and the risk factors for death in hemodialysis (HD) and peritoneal dialysis (PD) patients in a single center. Methods A total of 711 dialysis patients in our center were enrolled in this study. Twenty-nine patients with HS were divided by the outcome within 30 days into death group and survival group. Clinical and laboratory characteristics were compared between the two groups. Results HS occurred in 29 patients (26 cases on
HD, 3 cases on PD), significantly higher in HD patients than in PD patients (66.5/10,000 vs. 10.5/10,000 patient per year, P=0.002). Its mortality was 73.1% in HD patients and 67.7% in PD patients. Systolic blood pressure (SBP) at admission, diastolic blood pressure (DBP) at admission, size of hemorrhage area, incidence of intraventricular hematoma, and serum iPTH were significantly higher, and Glasgow coma score (GCS) were significantly lower (P<0.05) in death group than in survival group. The 30-day mortality was correlated with SBP at admission (r=0.562, P=0.004), DBP at admission (r=0.569, P=0.004), intraventricular hematoma (r= 0.402, P=0.042), size of hemorrhage area (r=0.612, P=0.001), iPTH (r=0.510, P=0.011), and GCS (r=-0.567, P=0.001). Kaplan-Meier curve showed that dialysis modality after HS had no impact on survival time of the patients (Log-rank test, P=0.545). Conclusion The 30-day mortality of HS was related to blood pressure at admission, severity of hemorrhagic stroke, and serum iPTH level in maintenance dialysis patients. Continuous renal replacement therapy and peritoneal dialysis after HS had no impact on their early outcome.

Key words: hemorrhagic stroke, maintenance dialysis, outcome, risk factors