4.5 Article

Chronic kidney disease correlates with MRI findings of cerebral small vessel disease

Journal

RENAL FAILURE
Volume 43, Issue 1, Pages 255-263

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/0886022X.2021.1873804

Keywords

Cerebral small vessel disease; chronic kidney disease; glomerular filtration rate; MRI; Virchow-Robin spaces

Funding

  1. Shanghai Science and Technology Commission Medical Guidance Project [18411967600]
  2. Shanghai Medical Rising Star Talent Fund
  3. National Natural Science Foundation of China [81671673, 81871329]
  4. Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant [2016427]
  5. Clinical Science and Technology Innovation Project of Shanghai Shen Kang Hospital Development Center [SHDC22015038]
  6. Shanghai Key Discipline of Medical Imaging [2017ZZ02005]

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The study found that patients with progressive chronic kidney disease have a higher prevalence and severity of cerebral small vessel disease, which is correlated with deterioration of renal function. Estimated Glomerular Filtration Rate (eGFR) may be useful in predicting cerebral small vessel disease.
Objective: Cerebral small vessel disease (CSVD) and chronic kidney disease (CKD) may be part of a multisystem small-vessel disorder. Since the kidney and brain share unique susceptibilities to vascular injury, kidney impairment may be predictive of the presence and severity of CSVD. This study explored the relationship between CSVD and CKD. Methods: Between December 2015 and December 2017 (follow-up 10-20 months) 52 patients with chronic nephritis and CKD were classified into a progressive group (n = 17) and stable group (n = 35). Age, gender, hypertension, diabetes and smoking were matched between groups. CSVD features of both groups, including enlarged Virchow-Robin spaces (VRS), white matter lesions (WML), lacunar infarcts (LI), and cerebral microbleeds (CMB) were evaluated by magnetic resonance (MR) imaging. Results: WML and CMB in the progressive group were exacerbated at follow-up compared to initial exam (p = 0.004 and 0.041, respectively). There was no significant change in VRS, WML, LI, or CMB in the stable group at follow-up compared to initial exam. CMB were significantly different between the progressive group and stable group at follow-up.etimtaed Glomerular filtration rate (eGFR) was significantly correlated with VRS, WML, and CMB at follow-up (p = 0.037, 0.041, and 0.009, respectively). Conclusions: Patients with progressive CKD have a higher prevalence and severity of CSVD, which correlates with deterioration of renal function as assessed by decreased eGFR. Thus EGFR may also be of value in the prediction of cerebral small vessel disease.

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