Chronic kidney disease as a risk factor for stroke

Chronic kidney disease (CKD) is a long-term kidney disease which  impacts on how the kidneys function. CKD can be caused by kidney stones, kidney infection and kidney inflammation. Some risk factors for CKD are similar to stroke for example high blood pressure, high cholesterol and diabetes.

Chronic kidney disease and stroke risk

People who have CKD have a higher risk of stroke and the risk of having a serious or fatal stroke is also increased. The risk of stroke is 5-30 times higher in those with chronic kidney disease (CKD), especially those receiving dialysis treatment1. Death rates from stroke in CKD patients are also higher, reaching almost 90%2.

The link between CKD and stroke may be due to enzymes and hormones released when there is kidney damage or failure, which can have a negative effect on the cardiovascular system. Patients with CKD also have higher rates of other stroke risk factors such as high blood pressure, diabetes, high lipids and atrial fibrillation2,3.

The evidence of the link between CKD and stroke demonstrates the importance of understanding the stroke risk factors in those with CKD and ensure that better preventative strategies are in place to reduce their rates and impact of stroke2,3,4.

Chronic kidney disease (CKD) has no cure, but treatment can manage symptoms and prevent it from worsening. The treatment will depend on the stage of CKD2,5:

  • Lifestyle changes to stay healthy
  • Medication to control related issues like high blood pressure and cholesterol
  • Dialysis (in advanced CKD to replace some kidney functions)
  • Kidney transplant (in advanced CKD)

Chronic kidney disease and stroke: Key points

People with chronic kidney disease (CKD) are at a higher risk of stroke at all stages of the disease by causing ongoing inflammation in the body. This in turn leads to damage in blood vessels and the heart, increasing the risk of stroke3.

Lifestyle changes, including prescribed exercise and treatment of other co-existing conditions can help symptoms and reduce risk.

References

  1. K Iseki and K Fukiyama. Predictors of stroke in patients receiving chronic hemodialysis. Kidney Int. 1996. 50:1672–5. https://doi.org/10.1038/ki.1996.484
  2. Nayak-Rao and M. P. Shenoy. Stroke in Patients with Chronic Kidney Disease…: How do we Approach and Manage it? Indian J Nephrol. 2017. May-Jun; 27(3): 67–171. https://doi.org/10.4103/0971-4065.202405
  3. Joachim Jankowski, Jürgen Floege, Danilo Fliser, Michael Böhm, Nikolaus Marx. Circulation. Cardiovascular Disease in Chronic Kidney Disease: Pathophysiological Insights and Therapeutic Options. 2021. 143(11). https://doi.org/10.1161/CIRCULATIONAHA.120.050686
  4. Rama Krishna, S. Naresh, G. S. R. Krishna, A. Y. Lakshmi, B. Vengamma, V. Siva Kumar. Stroke in chronic kidney disease. Indian J Nephrol. 2009. Jan; 19(1): 5–7. https://doi.org/10.4103/0971-4065.50672                                                                             
  5. M Connie, Dawn Edwards, Rebecca S. Ahdoot, James O. Burton, Paul T. Conway, Steven Fishbane, Daniel Gallego, Maurizio Gallieni. Living Well With Kidney Disease and Effective Symptom Management: Consensus Conference Proceedings. Kidney Int Rep. 2022. 7, 1951–1963; https://doi.org/10.1016/j.ekir.2022.06.01

 

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