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Decreased Kidney Function Is a Significant Factor Associated with Silent Cerebral Infarction and Periventricular HyperintensitiesShima H.a · Ishimura E.a · Naganuma T.b · Ichii M.a · Yamasaki T.b · Mori K.a · Nakatani T.b · Inaba M.a
aDepartments of Endocrinology, Metabolism, Molecular Medicine and Nephrology, and bDepartment of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan Corresponding Author
Eiji Ishimura, MD
Department of Nephrology
Osaka City University Graduate School of Medicine
1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585 (Japan)
Tel. +81 6 6645 3806, E-Mail firstname.lastname@example.org
Background/Aims: Silent cerebral lacunar infarction (SCI) and periventricular hyperintensities (PVH) have been reported to be markers of ischemic cerebral small-vessel disease and risk factors for future cerebrovascular events in the general population. The relationship between CKD and SCI/PVH is examined. Methods: In this cross-sectional study, brain magnetic resonance imaging was performed with a 1.5-T system in 324 predialysis CKD patients and in 60 normal subjects. Results: SCI was found in 103 CKD patients (31.8%), and PVH was found in 174 CKD patients (53.7%). SCI/PVH were more prevalent in patients with higher blood pressure, advanced age and decreased kidney function. There was a significant association between the prevalence of SCI/PVH and the CKD stage, with greater prevalence of SCI/PVH as the CKD stage advanced (p < 0.0001). PVH grade also advanced as the CKD stage advanced. The estimated glomerular filtration rate was a significant factor associated with the presence of SCI/PVH, independent of any other factors. There was a strong association between the prevalence of SCI/PVH (p < 0.0001). Conclusion: In CKD patients, decreased kidney function is a significant factor associated with SCI/PVH, both of which are significantly associated with each other. These results suggest that CKD patients with SCI/PVH are at greater risk of future cerebrovascular events.
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