Relationship Between Chronic Kidney Disease and White Matter Hyperintensities on Magnetic Resonance Imaging (original) (raw)

2012, Journal of Stroke and Cerebrovascular Diseases

Renal dysfunction may be related to cerebral small-vessel disease. This study aimed to assess the relationship between mild renal dysfunction and various white matter hyperintensities on magnetic resonance imaging (MRI). A total of 2106 subjects (1368 men and 738 women; mean age, 56 6 10 years) without a history of stroke were enrolled in the study. Kidney function was evaluated in terms of estimated glomerular filtration rate (eGFR), calculated using the relationship 194Cr 21.094 3 age 20.287 3 0.739 (if female), where Cr is serum creatinine concentration. White matter hyperintensity on T2-weighted MRI was classified as deep and/or subcortical white matter hyperintensity (DSWMH), periventricular hyperintensity (PVH), or asymptomatic cerebral infarction (ACI). The prevalence of ACI, DSWMH, and PVH was significantly correlated with degree of eGFR reduction; in the subgroups with eGFR $90, 6089, and ,60 mL/min/1.73 m 2 , the following prevalences were found: ACI, 7%, 6%, and 16%; DSWMH, 18%, 21%, and 37%; PVH: 7%, 10%, and 21%. The odds ratios for ACI, DSWMH, and PVH of eGFR ,60 mL/min/1.73 m 2 were significantly increased, to 2.11 (95% confidence interval [CI], 1.23-3.61; P 5 .006), 2.26 (1.53-3.34; P ,.001), and 2.81 (1.67-4.72; P ,.001), respectively. Our data indicate that mild renal dysfunction may be associated with an increase in cerebral small-vessel disease independent of hypertension. Key Words: Renal dysfunction-C-reactive protein-asymptomatic cerebral infarction-Cerebral small-vessel disease-cerebrovascular risk factor-glomerular filtration rate. Ó 2012 by National Stroke Association White matter hyperintensity is often detected on magnetic resonance imaging (MRI) in elderly persons 1-3 and hypertensive subjects, 1,2 and is considered a marker of cerebral small-vessel disease. Renal dysfunction is significantly correlated with white matter hyperintensity volume on MRI, and may be a predictor of cerebral small-vessel disease. 4,5 However, although white matter hyperintensity on MRI is thought to be related to various pathological lesions, 6-8 little is known about the relationship between these lesions and renal dysfunction. 5