Kidney function is related to cerebral small vessel disease
Kidney function is related to cerebral small vessel disease
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DOI：
10.1161/strokeaha.107.493494
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发表时间：
2008-01-01
期刊：
影响因子：
8.3
通讯作者：
Breteler, Monique M. B.
中科院分区：
文献类型：
--
作者：
Ikram, M. Arfan;Vernooij, Meike W.;Breteler, Monique M. B.
背景和目的：肾小球滤过率（GFR）测量的肾功能差与肾小球小血管疾病的存在密切相关。鉴于肾脏和大脑血管床的血流动力学相似性，我们假设肾脏功能与MRI上的脑小血管疾病标志物之间存在关联。我们在一项以老年人为基础的人群研究中调查了这种关联。方法：我们使用Cockcroft-Gault方程测量了来自鹿特丹扫描研究的484名参与者（60 - 90岁）的GFR。使用自动mri分析，我们测量了灰质和白质的整体、大叶和深部体积，以及WML的体积。目测腔隙性梗死程度。深部白质和脑白质的体积以及腔隙性梗死的存在反映了脑血管疾病。我们使用线性和逻辑回归模型来研究GFR与脑成像参数之间的关系。分析根据年龄、性别和心血管危险因素进行调整。结果：GFR较低的患者深部白质体积较少（GFR每SD减少的标准化体积差异：-0.15 [95% CI-0.26至0.04]），WML较多（GFR每SD减少的差异：0.14 [95% CI 0.03至0.25]），并且更经常发生腔隙性梗死，尽管后者并不显著。GFR与脑灰质体积或脑白质体积无关。对心血管危险因素的额外调整也产生了类似的结果。结论：肾功能受损与MRI评估的脑血管疾病标志物相关。
Background and Purpose-Poor kidney function, as measured by glomerular filtration rate (GFR), is closely associated with presence of glomerular small vessel disease. Given the hemodynamic similarities between the vascular beds of the kidney and the brain, we hypothesized an association between kidney function and markers of cerebral small vessel disease on MRI. We investigated this association in a population-based study of elderly persons.Methods-We measured GFR using the Cockcroft-Gault equation in 484 participants (60 to 90 years of age) from the Rotterdam Scan Study. Using automated MRI-analysis we measured global as well as lobar and deep volumes of gray matter and white matter, and volume of WML. Lacunar infarcts were rated visually. Volumes of deep white matter and WML and presence of lacunar infarcts reflected cerebral small vessel disease. We used linear and logistic regression models to investigate the association between GFR and brain imaging parameters. Analyses were adjusted for age, sex, and additionally for cardiovascular risk factors.Results-Persons with lower GFR had less deep white matter volume (difference in standardized volume per SD decrease in GFR:-0.15 [95% CI-0.26 to-0.04]), more WML (difference per SD decrease in GFR: 0.14 [95% CI 0.03 to 0.25]), and more often lacunar infarcts, although the latter was not significant. GFR was not associated with gray matter volume or lobar white matter volume. Additional adjustment for cardiovascular risk factors yielded similar results.Conclusions-Impaired kidney function is associated with markers of cerebral small vessel disease as assessed on MRI.