Manjula Kurella Tamura1, Nicholas M Pajewski2, R Nick Bryan2, Daniel E Weiner2, Matthew Diamond2, Peter Van Buren2, Addison Taylor2, Srinivasan Beddhu2, Clive Rosendorff2, Hesamoddin Jahanian2, Greg Zaharchuk2. 1. From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY. mktamura@stanford.edu. 2. From the Geriatric Research and Education Clinical Center (M.K.T.), Palo Alto VA Health Care System; Division of Nephrology (M.K.T.) and Department of Radiology (H.J., G.Z.), Stanford University School of Medicine, Palo Alto, CA; Department of Biostatistical Sciences (N.M.P.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology (R.N.B.), University of Pennsylvania, Philadelphia; Division of Nephrology (D.E.W.), Tufts Medical Center, Boston, MA; Division of Nephrology (M.D.), Georgia Regents University, Augusta; Department of Medicine (P.V.B.), University of Texas Southwestern Medical Center, Dallas; Department of Medicine (A.T.), Baylor College of Medicine, Houston, TX; Division of Nephrology (S.B.), University of Utah, Salt Lake City; and Division of Cardiology (C.R.), Icahn School of Medicine and James J. Peters VA, New York, NY.
Abstract
OBJECTIVE: To determine the relation between markers of kidney disease-estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR)-with cerebral blood flow (CBF) and white matter volume (WMV) in hypertensive adults. METHODS: We used baseline data collected from 665 nondiabetic hypertensive adults aged ≥50 years participating in the Systolic Blood Pressure Intervention Trial (SPRINT). We used arterial spin labeling to measure CBF and structural 3T images to segment tissue into normal and abnormal WMV. We used quantile regression to estimate the association between eGFR and UACR with CBF and abnormal WMV, adjusting for sociodemographic and clinical characteristics. RESULTS: There were 218 participants (33%) with eGFR <60 mL/min/1.73 m(2) and 146 participants (22%) with UACR ≥30 mg/g. Reduced eGFR was independently associated with higher adjusted median CBF, but not with abnormal WMV. Conversely, in adjusted analyses, there was a linear independent association between UACR and larger abnormal WMV, but not with CBF. Compared to participants with neither marker of CKD (eGFR ≥60 mL/min/1.73 m(2) and UACR <30 mg/g), median CBF was 5.03 mL/100 g/min higher (95% confidence interval [CI] 0.78, 9.29) and abnormal WMV was 0.63 cm(3) larger (95% CI 0.08, 1.17) among participants with both markers of CKD (eGFR <60 mL/min/1.73 m(2) and UACR ≥30 mg/g). CONCLUSIONS: Among nondiabetic hypertensive adults, reduced eGFR was associated with higher CBF and higher UACR was associated with larger abnormal WMV.
RCT Entities:
OBJECTIVE: To determine the relation between markers of kidney disease-estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR)-with cerebral blood flow (CBF) and white matter volume (WMV) in hypertensive adults. METHODS: We used baseline data collected from 665 nondiabetic hypertensive adults aged ≥50 years participating in the Systolic Blood Pressure Intervention Trial (SPRINT). We used arterial spin labeling to measure CBF and structural 3T images to segment tissue into normal and abnormal WMV. We used quantile regression to estimate the association between eGFR and UACR with CBF and abnormal WMV, adjusting for sociodemographic and clinical characteristics. RESULTS: There were 218 participants (33%) with eGFR <60 mL/min/1.73 m(2) and 146 participants (22%) with UACR ≥30 mg/g. Reduced eGFR was independently associated with higher adjusted median CBF, but not with abnormal WMV. Conversely, in adjusted analyses, there was a linear independent association between UACR and larger abnormal WMV, but not with CBF. Compared to participants with neither marker of CKD (eGFR ≥60 mL/min/1.73 m(2) and UACR <30 mg/g), median CBF was 5.03 mL/100 g/min higher (95% confidence interval [CI] 0.78, 9.29) and abnormal WMV was 0.63 cm(3) larger (95% CI 0.08, 1.17) among participants with both markers of CKD (eGFR <60 mL/min/1.73 m(2) and UACR ≥30 mg/g). CONCLUSIONS: Among nondiabetic hypertensive adults, reduced eGFR was associated with higher CBF and higher UACR was associated with larger abnormal WMV.
Authors: S Vorstrup; P Lass; G Waldemar; L Brandi; J F Schmidt; A Johnsen; O B Paulson Journal: J Cereb Blood Flow Metab Date: 1992-09 Impact factor: 6.200
Authors: Daniel E Weiner; Hocine Tighiouart; Andrew S Levey; Essam Elsayed; John L Griffith; Deeb N Salem; Mark J Sarnak Journal: J Am Soc Nephrol Date: 2007-02-14 Impact factor: 10.121
Authors: M Briet; E Bozec; S Laurent; C Fassot; G M London; C Jacquot; M Froissart; P Houillier; P Boutouyrie Journal: Kidney Int Date: 2006-01 Impact factor: 10.612
Authors: Saloua Akoudad; Sanaz Sedaghat; Albert Hofman; Peter J Koudstaal; Aad van der Lugt; M Arfan Ikram; Meike W Vernooij Journal: Int J Stroke Date: 2015-03-05 Impact factor: 5.266
Authors: George A Mensah; Zorina S Galis; Lawrence J Fine; Melissa E Garcia; Daniel F Levy; Gary H Gibbons Journal: Hypertension Date: 2016-11-14 Impact factor: 10.190
Authors: Prashanthi Vemuri; David S Knopman; Clifford R Jack; Emily S Lundt; Stephen D Weigand; Samantha M Zuk; Kaely B Thostenson; Robert I Reid; Kejal Kantarci; Yelena Slinin; Kamakshi Lakshminarayan; Cynthia S Davey; Anne Murray Journal: J Alzheimers Dis Date: 2017 Impact factor: 4.472
Authors: Mirela Dobre; Sarah A Gaussoin; Jeffrey T Bates; Michel B Chonchol; Debbie L Cohen; Thomas H Hostetter; Kalani L Raphael; Addison A Taylor; Alan J Lerner; Jackson T Wright; Mahboob Rahman Journal: Clin J Am Soc Nephrol Date: 2018-03-22 Impact factor: 8.237
Authors: Daniel E Weiner; Sarah A Gaussoin; John Nord; Alexander P Auchus; Gordon J Chelune; Michel Chonchol; Laura Coker; William E Haley; Anthony A Killeen; Paul L Kimmel; Alan J Lerner; Suzanne Oparil; Mohammad G Saklayen; Yelena M Slinin; Clinton B Wright; Jeff D Williamson; Manjula Kurella Tamura Journal: Am J Kidney Dis Date: 2017-06-09 Impact factor: 8.860
Authors: Kayla A Steward; Richard Kennedy; Guray Erus; Ilya M Nasrallah; Virginia G Wadley Journal: Neuropsychologia Date: 2019-05-04 Impact factor: 3.139
Authors: Barry I Freedman; Crystal A Gadegbeku; R Nick Bryan; Nicholas M Pajewski; Jasmin Divers; Nicholette D Palmer; Pamela J Hicks; Lijun Ma; Michael V Rocco; S Carrie Smith; Jianzhao Xu; Christopher T Whitlow; Benjamin C Wagner; Carl D Langefeld; Amret T Hawfield; Jeffrey T Bates; Alan J Lerner; Dominic S Raj; Mohammad S Sadaghiani; Robert D Toto; Jackson T Wright; Donald W Bowden; Jeff D Williamson; Kaycee M Sink; Joseph A Maldjian Journal: Kidney Int Date: 2016-06-22 Impact factor: 10.612
Authors: Hua-Shan Liu; Abbas F Jawad; Nina Laney; Erum A Hartung; Susan L Furth; John A Detre Journal: J Neuroradiol Date: 2018-03-28 Impact factor: 3.447
Authors: Hua-Shan Liu; Erum A Hartung; Abbas F Jawad; Jeffrey B Ware; Nina Laney; Allison M Port; Ruben C Gur; Stephen R Hooper; Jerilynn Radcliffe; Susan L Furth; John A Detre Journal: Radiology Date: 2018-06-12 Impact factor: 11.105