title: Renal dysfunction is associated with deep cerebral microbleeds but not white matter hyperintensities in patients with acute intracerebral hemorrhage.
abstract: Kidney disease is a risk factor for cerebral microangiopathy and spontaneous intracerebral hemorrhage (ICH). We aimed to determine the association of renal dysfunction (RD) with MRI correlates of different patterns of cerebral microangiopathies including cerebral microbleeds (CMB) and white matter lesions (WML) in patients with ICH. In a prospectively collected, single-center cohort of ICH patients, glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease equation. We classified the renal function in five categories: category 1 (eGFR ≥ 90 mL/min/1.73 m(2)), category 2 (eGFR 60-89), category 3 (eGFR 30-59), category 4 (eGFR 15-29), and category 5 (eGFR <15) and dichotomized at an eGFR of 60. Number, location, and extent of CMB and WML were measured on MRI. ICH and CMB locations were classified as lobar or deep. 97 ICH patients with MRI (mean age 65.9 ± 13.9 years) were included. Intracerebral hemorrhage was lobar in 52.6 %. Median eGFR was 85.8 mL/min/1.73 m(2) (IQR 34.3). Renal dysfunction was present in 12.4 % of the patients. At least one CMB was present in 57.7 % of patients, WML were even more frequent (97.7 %). Age and impaired renal function were factors independently associated with the presence of CMB. The presence of CMB was independently associated with the number and extent of WML. RD is a frequent comorbidity in patients with ICH. Associations of RD with hypertension and with CMB in deep location suggest a predominant impact of RD on deep rather than on lobar microangiopathy.
authors.affiliation: Department of Neurology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany. mona.laible@med.uni-heidelberg.de.
authors.forename: Mona
authors.initials: M
authors.lastname: Laible
authors.affiliation: Department of Neurology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.
authors.forename: Solveig
authors.initials: S
authors.lastname: Horstmann
authors.affiliation: Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Möhlenbruch
authors.affiliation: Department of Neurology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wegele
authors.affiliation: Department of Neurology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.
authors.forename: Timolaos
authors.initials: T
authors.lastname: Rizos
authors.affiliation: Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Schüler
authors.affiliation: Department of Internal Medicine-I, University of Heidelberg, Heidelberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Zorn
authors.affiliation: Department of Neurology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.|Department of Stroke Medicine, Imperial College London, London, UK.
authors.forename: Roland
authors.initials: R
authors.lastname: Veltkamp
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D059345:Cerebral Small Vessel Diseases / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000453:epidemiology; D066127:White Matter / Q000473:pathology*
keywords: Cerebral microbleeds; Cerebral white matter lesions; Intracerebral hemorrhage; Renal failure