Abstract TP199: Cerebral Microblees and Chronic Kidney Disease in Patients With First-ever Acute Ischemic Stroke or Transient Ischemic Attack

Abstract

Introduction: Cerebral microbleeds (CMBs) are extravasations of cerebral small vessels that manifest as small round homogenous deposits of hemosiderin, shown as signal loss on magnetic resonance imaging (MRI) T2*-weighted gradient-recalled echo. CMBs is a potential predictor of symptomatic stroke. The frequency of CMBs increases with age, hypertension and history of cerebrovascular disease. Some studies indicated the relationship between the CMBs and chronic kidney disease (CKD), but it remains unclear in patients with first-ever acute ischemic stroke (AIS) or transient ischemic attack (TIA). Our hypothesis is that the presence of CMBs is relative to the severity of CKD in patients with first-ever AIS or TIA. Methods: A single center retrospective study of 456 consecutive Japanese patients (mean age 71 years, 58.6% male) with first-ever AIS or TIA and early underwent 1.5T MRI T2*-weighted gradient-recalled echo were enrolled. CMBs were defined as homogeneous round signal-loss lesions with a diameter of <10 mm on 1.5T MRI T2*-weighted gradient-recalled echo. CKD stages were classified as normal (glomerular filtration rate (GFR): ≥90 mL/min/1.73 m 2 ), mild CKD (GFR: 60-89.9 mL/min/1.73 m 2 ), moderate CKD (GFR: 30-59.9 mL/min/1.73 m 2 ), and severe CKD (GFR: <30 mL/min/1.73 m 2 ). Multivariable logistic regression was used to determine associations of CMBs and severity of CKD and reported with odds ratios (OR) and 95% confidence intervals (CI). Results: The prevalence of CMBs in 141 (30.9%) of patients (10.5% had one CMBs, 10.5% had 2-4 CMBs and 9.9% had ≥5 CMBs), 7.4% strictly lobar CMBs and 23.5% deep/infratentorial CMBs. Compared with the reference group of normal, mild CKD (OR 2.54, 95% CI 1.17-6.15), moderate CKD (OR 2.87, 95% CI 1.20-7.51), and severe CKD (OR 5.95, 95% CI 1.68-21.7) were associated with the presence of deep/infratentorial CMBs but not strictly lobar CMBs. Conclusions: The presence of deep/infratentorial CMBs was significantly associated with severity of CKD in this population of first-ever AIS or TIA.