Cerebral microbleeds and intracerebral hemorrhages in patients on maintenance hemodialysis.

Cerebrovascular and cardiovascular diseases are the leading causes of death in patients undergoing maintenance hemodialysis. Recently, it has become clear that the appearance of cerebral microbleeds (MBs) on T2*-weighted magnetic resonance imaging (MRI) is closely related to intracerebral hemorrhage. The present study investigated the incidence of MBs in patients undergoing chronic dialysis and the effect of maintenance hemodialysis on the appearance of MBs. A total of 80 patients (34 males and 46 females) with chronic renal failure, mean age 62.9 +/- 11.4 years, were examined by MRI. The mean duration of hemodialysis was 7.8 +/- 6.3 years. MBs were found in 28 patients (35%) by T2*-weighted MRI. The duration of hemodialysis did not significantly affect the appearance of the MBs. Old intracerebral hemorrhages were seen in 7 of the patients, 5 of whom (71%) had MBs. The frequency of old intracerebral hemorrhages was significantly higher in the patients with MBs than in those without MBs (P = .048), and the patients with old intracerebral hemorrhages had significantly more MBs than the patients without them (P = .0065). This study found a high incidence of MBs in patients on maintenance hemodialysis, a correlation between MBs and intracerebral hemorrhage, but no correlation between the duration of hemodialysis and the appearance of MBs. The high ratio of patients with MBs was considered to have been caused not by maintenance hemodialysis, but by other factors, such as hypertension.