ESC Congress 2026 Abstract · Oct 26, 2026

Risk factors associated with stroke in end-stage renal disease patients undergoing haemodialysis: a nationwide population-based cohort study

By Jung L, Kim SW, Lee JY et al.

Background: End-stage renal disease (ESRD) patients on haemodialysis carry a substantially elevated stroke risk. However, data from large East Asian cohorts remain scarce. Purpose: To identify independent clinical risk factors associated with stroke in a nationwide cohort of haemodialysis patients. Methods: Adults aged ≥19 years receiving haemodialysis were identified from a nationwide health insurance claims database (2012–2022). Stroke was defined using ICD-10 codes I60–I64. Patients were classified as stroke versus no-stroke. Baseline characteristics were compared using chi-square tests and independent t-tests. Independent predictors were identified by multivariate logistic regression and expressed as odds ratios (OR) with 95% confidence intervals (CI). Results: Among 155,672 haemodialysis patients, 7,872 (5.1%) experienced stroke. Compared with the no-stroke group, stroke patients were older (67.4 ± 11.8 vs 65.3 ± 14.5 years, p<0.001), and had higher prevalence of prior stroke (28.9% vs 10.3%), diabetes mellitus (60.5% vs 48.5%), hypertension (51.0% vs 47.9%), atrial fibrillation (AF; 3.4% vs 2.9%), and peripheral arterial occlusive disease (PAOD; 6.2% vs 5.1%) (all p<0.05). Multivariate analysis identified four major independent risk factors: prior stroke (OR 3.099, 95% CI 2.938–3.269), diabetes mellitus (OR 1.448, 95% CI 1.380–1.519), AF (OR 1.164, 95% CI 1.019–1.329), and hypertension (OR 1.091, 95% CI 1.041–1.142) (all p<0.05). Older age (OR 1.002 per year, 95% CI 1.000–1.004, p=0.024) and female sex (OR 0.935, 95% CI 0.891–0.981, p=0.006) were also independently associated. Conclusions: In a nationwide cohort of over 155,000 haemodialysis patients, prior stroke, diabetes mellitus, AF, and hypertension are the major independent risk factors for stroke, with prior stroke conferring more than three-fold increased odds. These findings highlight the importance of targeted secondary prevention and aggressive risk factor management in ESRD patients on haemodialysis.Table 1Figure 1

doi.org/10.1093/eurheartj/ehag785.3976Open accessPopulations