Lulu Xiao1, Wenya Lan1, Wen Sun1, Qiliang Dai1, Yunyun Xiong1, Ling Li1, Yan Zhou1, Ping Zheng1, Wenping Fan1, Nan Ma1, Zhiliang Guo1, Xin Chen1, Xia Xie1, Lili Xu1, Wusheng Zhu2, Gelin Xu1, Xinfeng Liu2. 1. From the Department of Neurology (L.X., W.S., Q.D., Y.X., W.F., N.M., Z.G., X.C., X.X., L.X., W.Z., G.X., X.L.), Department of Radiology (L.L.), and National Clinical Research Center of Kidney Diseases (Y.Z.), Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Geriatric Neurology, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China (W.L.); and Department of Medicine, Royal Melbourne Hospital, University of Melbourne (P.Z.). 2. From the Department of Neurology (L.X., W.S., Q.D., Y.X., W.F., N.M., Z.G., X.C., X.X., L.X., W.Z., G.X., X.L.), Department of Radiology (L.L.), and National Clinical Research Center of Kidney Diseases (Y.Z.), Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Geriatric Neurology, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China (W.L.); and Department of Medicine, Royal Melbourne Hospital, University of Melbourne (P.Z.). zwsemail@sina.com xfliu2@vip.163.com.
Abstract
BACKGROUND AND PURPOSE: The relationship between chronic kidney disease and cerebral small vessel disease (cSVD), especially enlarged perivascular spaces (EPVS), has not been fully understood. This study aimed to investigate the association of chronic kidney disease and EPVS, as well as the total burden of cSVD on magnetic resonance imaging, expressed by the simultaneous presence of multiple markers of cSVD, among patients with first-ever lacunar stroke. METHODS: Four hundred and thirteen consecutive patients were prospectively enrolled. Centrum semiovale and basal ganglia EPVS on T2-weighted magnetic resonance imaging, as well as other imaging markers of cSVD, including lacune, white matter lesions, and cerebral microbleeds, were rated using validated scales. Chronic kidney disease was defined as either reduced estimated glomerular filtration rate or the presence of proteinuria. RESULTS: After adjustments for potential confounders by logistic regression, proteinuria and impaired estimated glomerular filtration rate were correlated with the severity of EPVS in both centrum semiovale (odds ratio [OR] 2.59; 95% confidence interval [CI] 1.19-5.64 and OR 2.37; 95% CI 1.19-4.73) and basal ganglia (OR 5.12; 95% CI 2.70-12.10 and OR 4.17; 95% CI 2.08-8.37). A similar association was also found between proteinuria and low estimated glomerular filtration rate levels and the comprehensive cSVD burden (OR 2.13; 95% CI 1.10-4.14 and OR 5.59; 95% CI 2.58-12.08). CONCLUSIONS: Proteinuria and impaired estimated glomerular filtration rate are associated with increasing EPVS severity and, furthermore, accumulated magnetic resonance imaging burden of cSVD in patients with first-ever acute lacunar stroke.
BACKGROUND AND PURPOSE: The relationship between chronic kidney disease and cerebral small vessel disease (cSVD), especially enlarged perivascular spaces (EPVS), has not been fully understood. This study aimed to investigate the association of chronic kidney disease and EPVS, as well as the total burden of cSVD on magnetic resonance imaging, expressed by the simultaneous presence of multiple markers of cSVD, among patients with first-ever lacunar stroke. METHODS: Four hundred and thirteen consecutive patients were prospectively enrolled. Centrum semiovale and basal ganglia EPVS on T2-weighted magnetic resonance imaging, as well as other imaging markers of cSVD, including lacune, white matter lesions, and cerebral microbleeds, were rated using validated scales. Chronic kidney disease was defined as either reduced estimated glomerular filtration rate or the presence of proteinuria. RESULTS: After adjustments for potential confounders by logistic regression, proteinuria and impaired estimated glomerular filtration rate were correlated with the severity of EPVS in both centrum semiovale (odds ratio [OR] 2.59; 95% confidence interval [CI] 1.19-5.64 and OR 2.37; 95% CI 1.19-4.73) and basal ganglia (OR 5.12; 95% CI 2.70-12.10 and OR 4.17; 95% CI 2.08-8.37). A similar association was also found between proteinuria and low estimated glomerular filtration rate levels and the comprehensive cSVD burden (OR 2.13; 95% CI 1.10-4.14 and OR 5.59; 95% CI 2.58-12.08). CONCLUSIONS:Proteinuria and impaired estimated glomerular filtration rate are associated with increasing EPVS severity and, furthermore, accumulated magnetic resonance imaging burden of cSVD in patients with first-ever acute lacunar stroke.
Authors: Ashley A Penton; Helena Lau; Viken L Babikian; Julie Shulman; Anna Cervantes-Arslanian; Suhas Gangadhara; David Greer; Hugo J Aparicio; Jose R Romero Journal: Stroke Date: 2020-10-06 Impact factor: 7.914
Authors: Karl Mercieca; John Cain; Thomas Hansen; Laura Steeples; Amy Watkins; Fiona Spencer; Alan Jackson Journal: Sci Rep Date: 2016-02-29 Impact factor: 4.379
Authors: Bian Liu; Kui Kai Lau; Linxin Li; Caroline Lovelock; Ming Liu; Wilhelm Kuker; Peter M Rothwell Journal: Stroke Date: 2018-03-09 Impact factor: 7.914