Awareness of stroke among patients with chronic kidney disease on hemodialysis: a cross-sectional study

Authors

Keywords:

Renal insufficiency, chronic, Stroke, Awareness, Renal dialysis, Renal replacement therapy, Chronic kidney insufficiency, Chronic kidney disease, Knowledge about stroke, Hemodialysis, Kidney replacement therapy

Abstract

BACKGROUND: Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke.
OBJECTIVE: To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis.
DESIGN AND SETTING: Cross-sectional analytical study of patients with CKD on hemodialysis in northeastern Brazil.
METHODS: A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression.
RESULTS: A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20–0.82), older patients (OR, 0.24%; 95% CI, 0.09–0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23–0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke.
CONCLUSIONS: Patients on hemodialysis, especially women and older people, have little knowledge about stroke.

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Author Biographies

Orlando Vieira Gomes, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

MD, MSc. Nephrologist and Assistant Professor, University Hospital, School of Medicine, Universidade
Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.

Manoel Pereira Guimarães, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

Undergraduate Medicine Student, School of Medicine, Universidade Federal do Vale do São Francisco
(UNIVASF), Petrolina (PE), Brazil.

Bárbara Maria Batista Barbosa, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

MD. Physician and Specialist in Internal Medicine, University Hospital, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.

Christielle Lidianne Alencar Marinho, Universidade de Pernambuco, Recife, Pernambuco, Brazil

MSc. Nurse and Doctoral Student, Health Sciences Program, Universidade de Pernambuco (UPE), Recife
(PE), Brazil.

Jandir Mendonça Nicacio, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

MD, MSc. Hematologist and Assistant Professor, University Hospital, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil.

Matheus Pereira Barreira, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

Undergraduate Medicine Student, School of Medicine, Universidade Federal of Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.

Mateus de Sousa Rodrigues, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

MD. Physician and Neurosurgery Resident, University Hospital, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.

Leonardo Fernandes e Santana, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil

MD. Physician and Internal Medicine Resident, University Hospital, School of Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina (PE), Brazil.

Ubiracé Fernando Elihimas Júnior, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil

MD, MSc, PhD. Nephrologist, Nephrology Service, University Hospital, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil.

Paulo Adriano Schwingel, Universidade de Pernambuco, Recife, Pernambuco, Brazil

PhD. Sports Physiologist and Associate Professor, Human Performance Research Laboratory, Universidade de Pernambuco (UPE), Petrolina (PE), Brazil.

References

World Health Organization. Global Health Estimates 2020: Deaths by Cause, Age, Sex, by Country and by region, 2000-2019. Geneva: World Health Organization; 2020. Available from: https://www.who. int/data/gho/data/themes/mortality-and-global-health-estimates/ ghe-leading-causes-of-death. Accessed in 2023 (May 2).

Araújo JP, Darcis JV, Tomas AC, Mello WA. Mortality trend due to cerebrovascular accidents in the city of Maringá, Paraná between the years of 2005 to 2015. Int J Cardiovasc Sci. 2018;31(1):56-62. http:// dx.doi.org/10.5935/2359-4802.20170097.

Kelly DM, Ademi Z, Doehner W, et al. Chronic kidney disease and cerebrovascular disease: consensus and guidance from a KDIGO Controversies Conference. Stroke. 2021;52(7):e328-46. PMID: 34078109; http://dx.doi.org/10.1161/strokeaha.120.029680.

Doehner W, Ural D, Haeusler KG, et al. Heart and brain interaction in patients with heart failure: overview and proposal for a taxonomy. A position paper from the Study Group on Heart and Brain Interaction of the Heart Failure Association. Eur J Heart Fail. 2018;20(2):199-215. PMID: 29280256; http://dx.doi.org/10.1002/ejhf.1100.

Ding WY, Gupta D, Wong CF, Lip GYH. Pathophysiology of atrial fibrillation and chronic kidney disease. Cardiovasc Res. 2021;117(4):1046-59. PMID: 32871005; http://dx.doi.org/10.1093/cvr/cvaa258.

Al-Kawaz M, Omran SS, Parikh NS, et al. Comparative risks of ischemic stroke in atrial flutter versus atrial fibrillation. J Stroke Cerebrovasc Dis. 2018;27(4):839-44. PMID: 29223550; http://dx.doi.org/10.1016/j. jstrokecerebrovasdis.2017.10.025.

Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33. PMID: 32061315; http://dx.doi.org/10.1016/S0140-6736(20)30045-3.

Gomes ABAGR, Henrique M, Schoeps VA, et al. Popular stroke knowledge in Brazil: A multicenter survey during “World Stroke Day.” eNeurologicalSci. 2017;6:63-7. PMID: 29260013; http://dx.doi.

org/10.1016/j.ensci.2016.12.002.

Pontes-Neto OM, Silva GS, Feitosa MR, et al. Stroke awareness in Brazil: alarming results in a community-based study. Stroke. 2008;39(2):292-6. PMID: 18162624; http://dx.doi.org/10.1161/strokeaha.107.493908.

Rodrigues MS, Santana LF, Fernandes Castro AP, et al. Awareness towards stroke among high school students in Brazil: a cross-sectional study.

Sao Paulo Med J. 2022;140(4):525-30. PMID: 35508010; http://dx.doi. org/10.1590/1516-3180.2021.0659.r2.13102021.

Faria ACA, Martins MM, Schoeller SD, Matos LO. Care path of a person with stroke: from onset to rehabilitation. Rev Bras Enferm. 2017;70(3):495503. PMID: 28562796; http://dx.doi.org/10.1590/0034-7167-2016-0579.

Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med. 2007;4(10):e297. PMID: 17941715; http://dx.doi.org/10.1371/journal.pmed.0040297.

Sirisha S, Jala S, Vooturi S, Yada PK, Kaul S. Awareness, recognition, and response to stroke among the general public-an observational study. J Neurosci Rural Pract. 2021;12(4):704-10. PMID: 34737504; http://dx.doi. org/10.1055/s-0041-1735822.

Kharbach A, Obtel M, Achbani A, et al. Level of knowledge on stroke and associated factors: a cross-sectional study at primary health care centers in Morocco. Ann Glob Health. 2020;86(1):83. PMID: 32742941; http://dx.doi.org/10.5334/aogh.2885.

Krzystanek E, Krzak-Kubica A, Świat M, Galus W, Gawryluk J. Adequate knowledge of stroke symptoms, risk factors, and necessary actions in the general population of southern Poland. Brain Sci. 2020;10(12):1009. PMID: 33353075; http://dx.doi.org/10.3390/brainsci10121009.

Hissa-Teixeira K. Uma análise da estrutura espacial dos indicadores socioeconômicos do nordeste brasileiro (2000-2010). EURE. 2018;44(131):101-24. http://dx.doi.org/10.4067/S0250-71612018000100101.

Meira F, Magalhães D, Silva LS, Mendonça e Silva AC, Silva GS. Knowledge about stroke in Belo Horizonte, Brazil: a community-based study using an innovative video approach. Cerebrovasc Dis Extra. 2018;8(2):60-9. PMID: 29788007; http://dx.doi.org/10.1159/000488400.

Sug Yoon S, Heller RF, Levi C, Wiggers J, Fitzgerald PE. Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke. 2001;32(8):1926-30. PMID: 11486127; http:// dx.doi.org/10.1161/01.STR.32.8.1926.

Hickey A, Holly D, McGee H, Conroy R, Shelley E. Knowledge of stroke risk factors and warning signs in Ireland: development and application of the Stroke Awareness Questionnaire (SAQ). Int J Stroke. 2012;7(4):298-306. PMID: 22151425; http://dx.doi.org/10.1111/j.1747-4949.2011.00698.x.

Campos-Sousa RN, Soares VYR, Almeida KJS, et al. Knowledge of stroke among a Brazilian urban population. Arq Neuropsiquiatr. 2007;65(3a):587-91. PMID: 17876395; http://dx.doi.org/10.1590/S0004282X2007000400007.

Naguib R, Fayed A, AlFadhliah AB, et al. Awareness about stroke and proper actions to be taken; a room for improvement. J Stroke Cerebrovasc Dis. 2020;29(6):104794. PMID: 32224204; http://dx.doi. org/10.1016/j.jstrokecerebrovasdis.2020.104794.

Moawad El-Sayed Ebied E, Abdelkader Abdeldaiem N. Cerebrovascular stroke risk factors and level of knowledge among community-dwelling hypertensive elderly. Egypt J Heal Care. 2018;9(3):573-86. http://dx.doi. org/10.21608/ejhc.2018.207942.

Dolenc Šparovec E, Slabe D, Eržen I, Kovačič U. The importance of elderly people knowing basic first-aid measures. BMC Emerg Med. 2022;22(1):128. PMID: 35836111; http://dx.doi.org/10.1186/s12873-022-00675-9.

Sundseth A, Faiz KW, Rønning OM, Thommessen B. Factors related to knowledge of stroke symptoms and risk factors in a Norwegian stroke population. J Stroke Cerebrovasc Dis. 2014;23(7):1849-55. PMID: 24809671; http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.02.026.

Nerbass FB, Lima HD, Thomé FS, et al. Brazilian Dialysis Survey 2020. J Bras Nefrol. 202244(3):349-57. PMID: 35212702; http://dx.doi. org/10.1590/2175-8239-jbn-2021-0198.

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Published

2025-03-24

How to Cite

1.
Gomes OV, Guimarães MP, Barbosa BMB, Marinho CLA, Nicacio JM, Barreira MP, Rodrigues M de S, Santana LF e, Elihimas Júnior UF, Schwingel PA. Awareness of stroke among patients with chronic kidney disease on hemodialysis: a cross-sectional study. Sao Paulo Med J [Internet]. 2025 Mar. 24 [cited 2025 May 9];142(1):1-6. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2989

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