title: Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage.
abstract: OBJECTIVE
  To investigate the relationship between chronic kidney disease (CKD) and MRI-defined cerebral microbleeds (CMB), a harbinger of future intracerebral hemorrhage (ICH), among patients with a recent history of primary ICH.
  
  
  METHODS
  Using data from a predominantly black cohort of patients with a recent ICH-enrolled in an observational study between September 2007 and June 2011, we evaluated the association between CKD (defined as estimated low glomerular filtration rate<60 mL/min per 1.73 m(2)) and CMB on gradient-echo MRI. Multivariable models were generated to determine the contribution of CKD to the presence, number, and location of CMB.
  
  
  RESULTS
  Of 197 subjects with imaging data, mean age was 59 years, 48% were women, 73% were black, 114 (58%) had ≥1 CMBs, and 52 (26%) had CKD. Overall, CKD was associated with presence of CMB (adjusted odds ratio, 2.70; 95% confidence interval [CI], 1.10-6.59) and number of CMB (adjusted relative risk, 2.04; 95% CI, 1.27-3.27). CKD was associated with CMB presence (adjusted odds ratio, 3.44; 95% CI, 1.64-7.24) and number (adjusted relative risk, 2.46; 95% CI, 1.11-5.42) in black patients, but not CMB presence (adjusted odds ratio, 3.00; 95% CI, 0.61-14.86) or number (adjusted relative risk, 1.03; 95% CI: 0.22-4.89) in non-Hispanic white patients (interactions by race were statistically not significant).
  
  
  CONCLUSIONS
  CKD is associated with a greater presence and number of CMB in ICH patients, particularly in patients of black race. Future studies should assess whether low estimated glomerular filtration rate may be a CMB risk marker or potential therapeutic target for mitigating the development of CMB.
authors.affiliation: Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA. ovibes@musc.edu
authors.forename: Bruce
authors.initials: B
authors.lastname: Ovbiagele
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Wing
authors.forename: Ravi S
authors.initials: RS
authors.lastname: Menon
authors.forename: Richard E
authors.initials: RE
authors.lastname: Burgess
authors.forename: M Christopher
authors.initials: MC
authors.lastname: Gibbons
authors.forename: Ian
authors.initials: I
authors.lastname: Sobotka
authors.forename: Laura
authors.initials: L
authors.lastname: German
authors.forename: Nawar M
authors.initials: NM
authors.lastname: Shara
authors.forename: Stephen
authors.initials: S
authors.lastname: Fernandez
authors.forename: Annapurni
authors.initials: A
authors.lastname: Jayam-Trouth
authors.forename: Dorothy Farrar
authors.initials: DF
authors.lastname: Edwards
authors.forename: Chelsea S
authors.initials: CS
authors.lastname: Kidwell
mesh_terms: D000368:Aged; D044383:Black People / Q000208:ethnology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D004219:District of Columbia / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012306:Risk; D044465:White People / Q000208:ethnology; D001741:Black or African American
keywords: MRI; antihypertensive therapy; black; cerebral hemorrhage; cerebral microbleeds; hemorrhagic stroke; prevalence; renal; renal insufficiency, chronic; renin–angiotensin; stroke