TY - JOUR T1 - Association of intermittent versus continuous hemodialysis modalities with mortality in the setting of acute stroke among patients with end-stage renal disease JF - Journal of Investigative Medicine JO - J Investig Med SP - 1513 LP - 1519 DO - 10.1136/jim-2022-002439 VL - 70 IS - 7 AU - Michael C Morgan AU - Jennifer L Waller AU - Wendy B Bollag AU - Stephanie L Baer AU - Sarah Tran AU - Mufaddal F Kheda AU - Lufei Young AU - Sandeep Padala AU - Budder Siddiqui AU - Azeem Mohammed Y1 - 2022/10/01 UR - http://hw-f5-jim.highwire.org/content/70/7/1513.abstract N2 - Patients with end-stage renal disease (ESRD) are 8–10 times more likely to suffer from a stroke compared with the general public. Despite this risk, there are minimal data elucidating which hemodialysis modality is best for patients with ESRD following a stroke, and guidelines for their management are lacking. We retrospectively queried the US Renal Data System administrative database for all-cause mortality in ESRD stroke patients who received either intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT). Acute ischemic stroke and hemorrhagic stroke were identified using the International Classification of Diseases 9th Revision (ICD-9)/ICD-10 codes, and hemodialysis modality was determined using Healthcare Common Procedure Coding System (HCPCS) codes. Time to death from the first stroke diagnosis was the outcome of interest. Cox proportional hazards modeling was used, and associations were expressed as adjusted HRs. From the inclusion cohort of 87,910 patients, 92.9% of patients received IHD while 7.1% of patients received CRRT. After controlling for age, race, sex, ethnicity, and common stroke risk factors such as hypertension, diabetes, tobacco use, atrial fibrillation, and hyperlipidemia, those who were placed on CRRT within 7 days of a stroke had an increased risk of death compared with those placed on IHD (HR=1.28, 95% CI 1.25 to 1.32). It is possible that ESRD stroke patients who received CRRT are more critically ill. However, even when the cohort was limited to only those patients in the intensive care unit and additional risk factors for mortality were controlled for, CRRT was still associated with an increased risk of death (HR=1.32, 95% CI 1.27 to 1.37). Therefore, further prospective clinical trials are warranted to address these findings.Data are available upon reasonable request. The USRDS data set used for this study can be requested from the National Institute of Diabetes and Digestive and Kidney Diseases using the following link: https://www.usrds.org/for-researchers/simple-data-requests/. ER -