title: Kidney function is associated with severity of white matter hyperintensity in patients with acute ischemic stroke/TIA.
abstract: BACKGROUND
  Previous studies suggested the potential interactions between cerebrovascular diseases and impaired renal function. However, the relationship between renal function and white matter hyperintensity (WMH), marker of cerebral small vessel disease, in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) remains unknown.
  
  
  METHODS
  We consecutively enrolled 1632 subjects with AIS or TIA who underwent brain MRI for this analysis. The severity of WMH in both of periventricular (PVH) and deep subcortical white matter (SDWMH) was evaluated using Fazekas scale. Estimated glomerular filtration rate (eGFR) was calculated by the equation of the Modification Diet for Renal Disease. Multinomial logistic regression was performed to evaluate the association between the severity of WMH and eGFR.
  
  
  RESULTS
  Advanced age and hypertension were independently associated with the severity of both PVH and SDWMH (all p < 0.001). There is a significantly inverse association between eGFR and PVH. Patients having each 30 ml/min/1.73 m2increase in eGFR was associated with 75 % of risk of having degree 3 of WMH in periventricular areas compared with degree 0 (p = 0.04, OR = 0.75, 95 % CI 0.61-0.92). However this inverse association was not found between eGFR and SDWMH (P = 0.50, OR = 0.93, 95 % CI0.75-1.14).
  
  
  CONCLUSIONS
  Our study demonstrates that renal dysfunction (eGFR) is independently associated with the severity of PVH but not SDWMH in patients with acute ischemic stroke. This results highlighted different pathological mechanism and risk factors of PVH and SDWMH.
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Zong
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Yao
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ni
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
authors.forename: Lixin
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Peng
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China. zhuych910@163.com.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Zhu
authors.affiliation: Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China. pumchcuily@sina.com.|Department of Neurology, Peking Union Medical College Hospital, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan, Beijing, 100730, China. pumchcuily@sina.com.
authors.forename: Liying
authors.initials: L
authors.lastname: Cui
mesh_terms: D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Chronic kidney disease; Renal dysfunction; Stroke; White matter hyperintensity