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Kidney Dysfunction is Associated with a High Burden of Cerebral Small Vessel Disease in Primary Intracerebral Hemorrhage

[ Vol. 15 , Issue. 1 ]

Author(s):

Mangmang Xu, Shihong Zhang, Jiaqi Liu, Hong Luo, Simiao Wu, Yajun Cheng and Ming Liu*   Pages 39 - 46 ( 8 )

Abstract:


Objectives: To investigate the association of kidney function with the total burden of Cerebral Small Vessel Disease (CSVD) in primary Intracerebral Hemorrhage (pICH).

Methods: Cerebral magnetic resonance imagings of consecutively enrolled pICH patients were reviewed to assess for lacunes, White Matter Hyperintensity (WMH), Cerebral Microbleeds (CMBs) and Enlarged Perivascular Spaces (EPVS). Minor refinements to the CSVD score, namely modified CSVD score 1 and 2, were made by incorporating different weightings of CSVD markers. Kidney function was assessed using the estimated Glomerular Filtration Rate (eGFR). We used ordinal regression analysis to assess the association of kidney function with the CSVD score and modified scores.

Results: In the 108 patients included, the presence of lacunes, CMBs, MWH and basal ganglia EPVS>10 was 27.8%, 67.6%, 47.2% and 35.2%, respectively. In multivariable ordinal regression, a decreasing eGFR value was associated with an increased CSVD score [Odds Ratio (OR) 0.978, 95% Confidence Interval (CI) 0.962 to 0.995, P=0.013], modified CSVD score 1 (OR 0.973, 95% CI 0.957 to 0.990, P=0.002) and 2 (OR 0.969, 95% CI 0.953 to 0.986, P<0.001). The link between eGFR and the total burden of CSVD was significant in strictly deep pICH (P=0.011 for CSVD score; P=0.001 for modified score 1 and 2), but not strictly lobar pICH in subgroup analysis.

Conclusions: Low eGFR is associated with a high burden of CSVD in patients with deep pICH, but not lobar pICH. Future studies are warranted to assess whether low eGFR is a potential therapeutic target for preventing the progress of CSVD burden for deep pICH.

Keywords:

Cerebral Small Vessel Disease score (CSVD), cerebral microbleed, white matter hyperintensity, primary intracerebral hemorrhage, kidney function, cognitive decline.

Affiliation:

Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, West China School of Medicine, Sichuan University, Chengdu, Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Center of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu



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