Chronic Kidney Disease in Patients With Lacunar Stroke
- 1 August 2015
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 46 (8), 2081-2086
- https://doi.org/10.1161/strokeaha.114.008155
Abstract
Background and Purpose—: The relationship between chronic kidney disease and cerebral small vessel disease (cSVD), especially enlarged perivascular spaces (EPVS), has not been fully understood. This study aimed to investigate the association of chronic kidney disease and EPVS, as well as the total burden of cSVD on magnetic resonance imaging, expressed by the simultaneous presence of multiple markers of cSVD, among patients with first-ever lacunar stroke. Methods—: Four hundred and thirteen consecutive patients were prospectively enrolled. Centrum semiovale and basal ganglia EPVS on T2-weighted magnetic resonance imaging, as well as other imaging markers of cSVD, including lacune, white matter lesions, and cerebral microbleeds, were rated using validated scales. Chronic kidney disease was defined as either reduced estimated glomerular filtration rate or the presence of proteinuria. Results—: After adjustments for potential confounders by logistic regression, proteinuria and impaired estimated glomerular filtration rate were correlated with the severity of EPVS in both centrum semiovale (odds ratio [OR] 2.59; 95% confidence interval [CI] 1.19–5.64 and OR 2.37; 95% CI 1.19–4.73) and basal ganglia (OR 5.12; 95% CI 2.70–12.10 and OR 4.17; 95% CI 2.08–8.37). A similar association was also found between proteinuria and low estimated glomerular filtration rate levels and the comprehensive cSVD burden (OR 2.13; 95% CI 1.10–4.14 and OR 5.59; 95% CI 2.58–12.08). Conclusions—: Proteinuria and impaired estimated glomerular filtration rate are associated with increasing EPVS severity and, furthermore, accumulated magnetic resonance imaging burden of cSVD in patients with first-ever acute lacunar stroke.This publication has 32 references indexed in Scilit:
- Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegenerationThe Lancet Neurology, 2013
- Mechanisms of sporadic cerebral small vessel disease: insights from neuroimagingThe Lancet Neurology, 2013
- Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysisBMJ, 2013
- Accumulation of MRI Markers of Cerebral Small Vessel Disease is Associated with Decreased Cognitive Function. A Study in First-Ever Lacunar Stroke and Hypertensive PatientsFrontiers in Aging Neuroscience, 2013
- GFR Estimating Equations in a Multiethnic Asian PopulationAmerican Journal of Kidney Diseases, 2011
- Clinical Interaction between Brain and Kidney in Small Vessel DiseaseCardiology Research and Practice, 2011
- Cerebral microbleeds: a guide to detection and interpretationThe Lancet Neurology, 2009
- Chronic Kidney Disease Is Associated With White Matter Hyperintensity VolumeStroke, 2007
- Relationship Between Aortic Stiffening and Microvascular Disease in Brain and KidneyHypertension, 2005
- Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and HospitalizationThe New England Journal of Medicine, 2004