title: Kidney dysfunction and cerebral microbleeds in neurologically healthy adults.
abstract: BACKGROUND
  Cerebral microbleed (CMB) is a potent risk factor for overt cerebrovascular disease. Although some studies indicated the possible role of renal dysfunction as a risk factor of CMB, the findings could not be generalized. This study aimed to investigate the association between renal dysfunction and cerebral microbleed (CMB) in neurologically healthy adults.
  
  
  METHODS
  A total of 2,518 subjects who underwent brain MRI as part of health screening were involved in the study. CMBs were defined as well-demarcated focal areas of low signal intensity with associated blooming on the T2-weighted MRI measuring less than 5mm in diameter. The glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease formula. Kidney function was classified as normal (≥90), mild (60 to 89.9), moderate (30 to 59.9), and severe (<30 mL/min/1.73 m2) renal dysfunction according to the GFR.
  
  
  RESULTS
  The mean age of the participants was 57.5 ± 8.3 years (ranged 40 to 79), and 1,367 subjects (54.3%) were male. The mean GFR level was 81.5 ± 15.5, and the prevalence of CMB was 4.1% (n = 103). Subjects with CMB demonstrated a higher proportion of moderate-to-severe renal dysfunction than those without CMB (15.5% vs. 5.0%, p < 0.001). In the multivariate logistic regression analysis, moderate-to-severe renal dysfunction showed a significant association with CMB (adjusted odd ratio = 2.63; p = 0.008). Furthermore, a decrease in the GFR level was associated with an increasing trend of the presence of CMB (p for trend = 0.031) and number of CMB lesions (p for trend = 0.003).
  
  
  CONCLUSIONS
  Renal dysfunction was significantly associated with the presence of CMB in neurologically healthy adults. More studies are needed to evaluate if treatment of kidney disease and risk factor modification may prevent further progress of CMB.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Sang Hyuck
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Yun
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Be Long
authors.initials: BL
authors.lastname: Cho
authors.affiliation: Department of Neurology, Seoul National University-Seoul Municipal Government Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Kwon
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors