title: Longitudinal relationship between chronic kidney disease and distribution of cerebral microbleeds in patients with ischemic stroke.
abstract: BACKGROUND
  Chronic kidney disease (CKD) has been reported to be independently associated with cerebral microbleeds (CMB). Since both glomerular afferent arterioles and cerebral perforating arteries are strain vessels, CKD and CMB may share similar dynamic changes.
  
  
  OBJECTIVE
  To clarify whether CKD and CKD progression are related to the distribution and evolution of CMB in patients with ischemic stroke.
  
  
  METHODS
  We retrospectively examined the data from the CASISP study. 500 patients with ischemic stroke were analyzed. The number and distribution of CMB were assessed using Microbleed Anatomical Rating Scale. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) and proteinuria.
  
  
  RESULTS
  51 (10.2%) and 158 (31.6%) had decreased eGFR (<60ml/min/1.73m(2)) and CMB at baseline, respectively; 31 (6.6%) and 84 (16.8%) had CKD and CMB progression. Decreased eGFR at baseline (OR=1.533, 95% CI: 1.111-2.114; p=0.009), proteinuria (OR=1.778, 95% CI: 1.026-3.083; p=0.040), CKD progression (OR=2.004, 95% CI: 1.191-3.370; p=0.009) and history of hypertension (OR=2.084, 95% CI: 1.241-3.49; p=0.005) were independently associated with the presence of deep or infratentorial CMB at follow-up. CMB progression in deep or infratentorial area was more frequent in patients with CKD progression than those without (29.0% versus 13.1%, p=0.028). Logistic regression analyses showed that CKD progression (OR=2.577, 95% CI: 1.393-4.769; p=0.003) was independently associated with the progression of deep or infratentorial CMB.
  
  
  CONCLUSIONS
  CKD and CKD progression are independently associated with presence and evolution of deep or infratentorial CMB, but not lobar CMB.
authors.affiliation: Department of Neurology, Peking University First Hospital, Beijing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Peng
authors.affiliation: Department of Neurology, Peking University First Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Neurology, Beijing Shijitan Hospital, Beijing, China.
authors.forename: Wenhong
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurology, Peking University First Hospital, Beijing, China.
authors.forename: Ran
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Neurology, Peking University First Hospital, Beijing, China. Electronic address: ynhuang@bjmu.edu.cn.
authors.forename: Yining
authors.initials: Y
authors.lastname: Huang
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology
chemical_list: D011933:Reagent Kits, Diagnostic
keywords: Cerebral microbleeds; Chronic kidney disease; Estimated glomerular filtration rate; Ischemic stroke; Small vessel disease