title: Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults.
abstract: OBJECTIVE
  To determine the relation between markers of kidney disease-estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR)-with cerebral blood flow (CBF) and white matter volume (WMV) in hypertensive adults.
  
  
  METHODS
  We used baseline data collected from 665 nondiabetic hypertensive adults aged ≥50 years participating in the Systolic Blood Pressure Intervention Trial (SPRINT). We used arterial spin labeling to measure CBF and structural 3T images to segment tissue into normal and abnormal WMV. We used quantile regression to estimate the association between eGFR and UACR with CBF and abnormal WMV, adjusting for sociodemographic and clinical characteristics.
  
  
  RESULTS
  There were 218 participants (33%) with eGFR <60 mL/min/1.73 m(2) and 146 participants (22%) with UACR ≥30 mg/g. Reduced eGFR was independently associated with higher adjusted median CBF, but not with abnormal WMV. Conversely, in adjusted analyses, there was a linear independent association between UACR and larger abnormal WMV, but not with CBF. Compared to participants with neither marker of CKD (eGFR ≥60 mL/min/1.73 m(2) and UACR <30 mg/g), median CBF was 5.03 mL/100 g/min higher (95% confidence interval [CI] 0.78, 9.29) and abnormal WMV was 0.63 cm(3) larger (95% CI 0.08, 1.17) among participants with both markers of CKD (eGFR <60 mL/min/1.73 m(2) and UACR ≥30 mg/g).
  
  
  CONCLUSIONS
  Among nondiabetic hypertensive adults, reduced eGFR was associated with higher CBF and higher UACR was associated with larger abnormal WMV.
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY. mktamura@stanford.edu.
authors.forename: Manjula Kurella
authors.initials: MK
authors.lastname: Tamura
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Pajewski
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: R Nick
authors.initials: RN
authors.lastname: Bryan
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Weiner
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Matthew
authors.initials: M
authors.lastname: Diamond
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Peter
authors.initials: P
authors.lastname: Van Buren
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Addison
authors.initials: A
authors.lastname: Taylor
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Beddhu
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Clive
authors.initials: C
authors.lastname: Rosendorff
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Hesamoddin
authors.initials: H
authors.lastname: Jahanian
authors.affiliation: From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
authors.forename: Greg
authors.initials: G
authors.lastname: Zaharchuk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D009929:Organ Size; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D066127:White Matter / Q000473:pathology*