{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:07:35Z","timestamp":1791176855846,"version":"4.1.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In patients undergoing hemodialysis, intracerebral hemorrhage (ICH) is the main cause of mortality among stroke subtypes. It is unclear whether, along with traditional cardiovascular risk factors, the risk factors unique to the uraemic environment, such as the abnormal metabolism of intact parathyroid hormone (iPTH), can contribute to the risk of ICH in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective case\u2013control study included 25 patients undergoing hemodialysis with ICH at a single center between 30 June 2015 and 10 October 2022. The controls were 95 patients undergoing maintenance hemodialysis treated at the same dialysis center in July 2020. We compared the characteristics of patients with ICH with those of the control group to identify factors that contributed to the development of ICH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intracerebral hemorrhage (ICH) was located in the basal ganglia (14\/25), cerebellum (6\/25), and brainstem (6\/25) in 25 patients. A total of 17 patients died in the first 16\u2009days due to neurological complications. Univariate analysis showed significant differences in systolic BP, diastolic BP, iPTH, and alkaline phosphatase between the two groups (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). Multivariate logistic regression analysis showed that higher systolic BP (OR, 1.053; 95% CI, 1.018\u20131.090; <jats:italic>p<\/jats:italic>\u2009=\u20090.003) and higher iPTH (OR, 1.007; 95% CI, 1.003\u20131.012; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) were associated with the onset of ICH. ICH was predicted by systolic BP and iPTH by receiver operating characteristic (ROC) curve analysis, with areas under the curve (AUCs) of 0.732 and 0.624, respectively. The optimal cutoffs for systolic BP and iPTH were 151.9\u2009mmHg and 295.4\u2009pg.\/ml, respectively. Restricted cubic spline showed that the shape of the association of iPTH with the risk of ICH was approximately J-shaped (P for non-linearity &amp;lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher systolic BP and abnormal iPTH metabolism might be associated with ICH in patients undergoing hemodialysis. Comprehensive control of hypertension and iPTH may be a fundamental preventive strategy for ICH in these patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1111865","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T06:14:04Z","timestamp":1679465644000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk factors for intracerebral hemorrhage in patients undergoing maintenance hemodialysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Song","family":"Yu-Huan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cai","family":"Guang-Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Yue-Fei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/1744-9987.12192","article-title":"Higher mortality due to intracerebral hemorrhage in dialysis patients: a comparison with the general population in Japan","volume":"19","author":"Wakasugi","year":"2015","journal-title":"Ther Apher Dial"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1080\/0886022X.2019.1659151","article-title":"Serum lipoprotein(a) and risk of hemorrhagic stroke among incident peritoneal dialysis patients: a large study from a single center in China","volume":"41","author":"Chen","year":"2019","journal-title":"Ren Fail"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.2215\/CJN.08350910","article-title":"Inflammatory markers and risk of cerebrovascular events in patients initiating dialysis","volume":"6","author":"Sozio","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.1161\/01.RES.87.7.e10","article-title":"Phosphate regulation of vascular smooth muscle cell calcification","volume":"87","author":"Jono","year":"2000","journal-title":"Circ Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1161\/STROKEAHA.116.013195","article-title":"Association between serum phosphate levels and stroke risk in patients undergoing hemodialysis: the Q-cohort study","volume":"47","author":"Yamada","year":"2016","journal-title":"Stroke"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s12882-019-1400-4","article-title":"Association between serum calcium levels and prognosis, hematoma volume, and onset of cerebral hemorrhage in patients undergoing hemodialysis","volume":"20","author":"Kitamura","year":"2019","journal-title":"BMC Nephrol"},{"key":"ref7","volume-title":"Secondary hyperparathyroidism. 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