Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults
Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults
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DOI：
10.1212/wnl.0000000000002527
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发表时间：
2016-03-29
期刊：
影响因子：
9.9
通讯作者：
Zaharchuk, Greg
中科院分区：
文献类型：
--
作者：
Tamura, Manjula Kurella;Pajewski, Nicholas M.;Zaharchuk, Greg
目的：探讨高血压成人肾脏疾病指标（肾小球滤过率（eGFR）、尿白蛋白/肌酐比（UACR））与脑血流量（CBF）、脑白质体积（WMV）的关系。方法：我们使用了参加收缩压干预试验（SPRINT）的665名50岁非糖尿病高血压成年人的基线数据。我们使用动脉自旋标记测量CBF和结构3T图像将组织划分为正常和异常WMV。我们使用分位数回归来估计eGFR和UACR与CBF和异常WMV之间的关系，并根据社会人口学和临床特征进行调整。结果：218例（33%）受试者eGFR = 30 mg/g。eGFR降低与调节中位CBF升高独立相关，但与WMV异常无关。相反，在校正分析中，UACR与较大的异常WMV之间存在线性独立关联，但与CBF无关。与没有CKD标志物（eGFR >= 60 mL/min/1.73 m(2)）和UACR的参与者相比
Objective:To determine the relation between markers of kidney disease-estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR)-with cerebral blood flow (CBF) and white matter volume (WMV) in hypertensive adults.Methods:We used baseline data collected from 665 nondiabetic hypertensive adults aged >= 50 years participating in the Systolic Blood Pressure Intervention Trial (SPRINT). We used arterial spin labeling to measure CBF and structural 3T images to segment tissue into normal and abnormal WMV. We used quantile regression to estimate the association between eGFR and UACR with CBF and abnormal WMV, adjusting for sociodemographic and clinical characteristics.Results:There were 218 participants (33%) with eGFR = 30 mg/g. Reduced eGFR was independently associated with higher adjusted median CBF, but not with abnormal WMV. Conversely, in adjusted analyses, there was a linear independent association between UACR and larger abnormal WMV, but not with CBF. Compared to participants with neither marker of CKD (eGFR >= 60 mL/min/1.73 m(2) and UACR