title: Decreased kidney function is a significant factor associated with silent cerebral infarction and periventricular hyperintensities.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Endocrinology, Metabolism, Molecular Medicine and Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shima
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Toshihide
authors.initials: T
authors.lastname: Naganuma
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ichii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Mori
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakatani
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
mesh_terms: D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D002552:Cerebral Ventricles / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007677:Kidney Function Tests / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D012307:Risk Factors