title: Subclinical cerebral abnormalities in chronic kidney disease.
abstract: OBJECTIVE
  Impaired kidney function or chronic kidney disease (CKD), as measured by estimated glomerular filtration rate (eGFR), is associated with incident stroke risk. However, few studies have examined the relationship between CKD and subclinical cerebral abnormalities.
  
  
  METHODS
  We examined 675 elderly subjects (mean age 69.9 years), who were living independently at home without apparent dementia, using magnetic resonance imaging. Serum creatinine values, measured by the enzymatic method, were used for the Japanese equation of eGFR.
  
  
  RESULTS
  Subclinical lacunar infarction, deep white matter lesions, and periventricular hyperintensities were detected in 88 (13.0%), 240 (35.6%) and 158 (23.4%) of the 675 participants, respectively. In the forward stepwise method of logistic analysis, age (OR 2.081/10, 95% CI 1.541-2.810), hypertension (OR 3.656, 95% CI 2.184-6.119), diabetes mellitus (OR 1.961, 95% CI 1.007-3.820), alcohol intake (OR 2.130, 95% CI 1.283-3.535), and eGFR <45 ml/min/1.73 m(2) were significant factors concerning subclinical lacunar infarction. CKD defined as eGFR <60 ml/min/1.73 m(2) was not significantly associated with subclinical lacunar infarction. Decreased eGFR was not a significant factor associated with white matter lesions (WMLs). Age (OR 2.781/10, 95% CI 2.252-3.435), hypertension (OR 1.746, 95% CI 1.231-2.477), diabetes mellitus (OR 1.854, 95% CI 1.070-3.213), but not eGFR were significant factors concerning WMLs.
  
  
  CONCLUSIONS
  The present study showed that community-dwelling elderly subjects with late stage 3 CKD were at high risk for prevalent subclinical lacunar infarction. The identification of CKD-specific modifiable risk factors for SBI and WMLs is of increased importance for prevention of subclinical brain ischemic lesions.
authors: Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Saitama, Japan. hyao@hizen2.hosp.go.jp
authors: Hiroshi
authors: H
authors: Yao
authors: Yuki
authors: Y
authors: Takashima
authors: Manabu
authors: M
authors: Hashimoto
authors: Akira
authors: A
authors: Uchino
authors: Takefumi
authors: T
authors: Yuzuriha
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000453:epidemiology; D001921:Brain / Q000473:pathology*; D002545:Brain Ischemia / Q000517:prevention & control; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D057187:Independent Living; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology; D059409:Stroke, Lacunar / Q000453:epidemiology* / Q000473:pathology
chemical_list: D003404:Creatinine