Predictors for silent cerebral infarction in patients with chronic renal failure undergoing hemodialysis.
In patients with chronic renal failure undergoing hemodialysis (HD), silent cerebral infarctions (SCIs) are associated with high mortality. Levels of hepatocyte growth factor (HGF) increase with renal dysfunction and may be a novel predictor of cerebrovascular events. We examined if HGF is a predictor of SCI in HD patients. Brain magnetic resonance imaging findings were used to divide 50 patients undergoing HD into 2 groups, a group with SCI (age, 61 +/- 8 years, mean +/- SD; n = 27) and a group without SCI (age, 60 +/- 7 years; n = 23). These patients received 24-hour ambulatory blood pressure monitoring. The number of patients with diabetes or hypertension was not different between the 2 groups. We made the following observations: (1) The percentage of smokers was higher in the group with SCI than in the group without SCI (P < .05). (2) Plasma levels of high-density lipoprotein cholesterol were lower and HGF levels were higher in the group with SCI compared with the group without SCI (P < .05 and P < .005, respectively). (3) Systolic ambulatory blood pressure and mean heart rate at night were higher in the group with SCI than in the group without SCI (P < .05). Multiple logistic regression analysis identified HGF as a significant risk factor for SCI (odds ratio, 1.89; 95% confidence interval, 1.57-3.38; P < .005). Our findings indicate that HGF may be a novel useful predictor of SCI in patients with chronic renal failure undergoing HD.
Anan
Futoshi
F
Department of Cardiology, Oita Red Cross Hospital, Oita, Japan. anan-f@med.oita-u.ac.jp
Shimomura
Tsuyoshi
T
Imagawa
Masaharu
M
Masaki
Takayuki
T
Nawata
Tomoko
T
Takahashi
Naohiko
N
Yonemochi
Hidetoshi
H
Eshima
Nobuoki
N
Saikawa
Tetsunori
T
Yoshimatsu
Hironobu
H
D018660:Blood Pressure Monitoring, Ambulatory; D001921:Brain / Q000473:pathology; D002544:Cerebral Infarction / Q000097:blood / Q000150:complications* / Q000473:pathology; D015150:Echocardiography, Doppler; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications* / Q000628:therapy; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis
D017228:Hepatocyte Growth Factor