Association of Renal Dysfunction With Remote Diffusion-Weighted Imaging Lesions and Total Burden of Cerebral Small Vessel Disease in Patients With Primary Intracerebral Hemorrhage.

Xu-Hua Xu,Lu-Sha Tong,Ting Gao,Xiang-Hua Ye,Jin-Song Cai,Guo-Hua Zhao,Feng Gao,Wen-Ji Zhang

doi:10.3389/fnagi.2018.00171

Abstract

Objective: Remote diffusion-weighted imaging (DWI) lesions (R-DWIL) found in intracerebral hemorrhage (ICH) patients are considered as an additional marker of cerebral small vessel disease (cSVD). This study aimed to investigate the association of renal dysfunction and R-DWIL, as well as the total burden of cSVD on magnetic resonance imaging among patients with primary ICH.Methods: One hundred and twenty-six consecutive patients were prospectively enrolled. R-DWIL on DWI, as well as other imaging markers of cSVD, including lacunes, white matter lesions, cerebral microbleeds, and enlarged perivascular spaces were rated using validated scales. Renal dysfunction was evaluated either by reduced estimated glomerular filtration rate (eGFR) or the presence of proteinuria or increased cystatin C.Results: After adjustments for potential confounders by logistic regression, impaired eGFR [odds ratio (OR) 6.00, 95% confidence interval (CI) 1.73–20.78], proteinuria (OR 3.07, 95% CI 1.25–7.54) and increased cystatin C (OR 2.73, 95% CI 1.11–6.72) were correlated with presence of R-DWIL. A similar association was also found between cystatin C levels (OR 3.16, 95% CI 1.39–7.19), proteinuria (OR 2.79, 95% CI 1.34–5.83) and the comprehensive cSVD burden.Conclusions: Renal dysfunction are associated with the presence of R-DWIL, and total burden of cSVD in patients with primary ICH.

Highlights

Cerebral small vessel disease is an intrinsic disorder of the small perforating arterioles, and could increase the risks of stroke, mood disturbance, cognitive impairment, and balance disorder (Akoudad et al, 2015)
This study aimed to investigate the association of renal dysfunction and remote diffusion-weighted imaging (DWI) lesions (R-DWIL), as well as the total burden of Cerebral small vessel disease (cSVD) on magnetic resonance imaging among patients with primary intracerebral hemorrhage (ICH)
A similar association was found between cystatin C levels, proteinuria and the comprehensive cSVD burden

Summary

Introduction

Cerebral small vessel disease (cSVD) is an intrinsic disorder of the small perforating arterioles, and could increase the risks of stroke, mood disturbance, cognitive impairment, and balance disorder (Akoudad et al, 2015). Previous studies have demonstrated that renal dysfunction are associated with WMH, CMBs, EPVS, lacunes, and total cSVD load, a combined effect of all 4 markers (Ovbiagele et al, 2013; Oh et al, 2014; Staals et al, 2014; Zhang et al, 2014; Akoudad et al, 2015; Xiao et al, 2015; Banerjee et al, 2016; Yang et al, 2017) These studies mainly focused on patients of ischemic stroke, few on patients of primary ICH. In this study, we aimed to investigate the association of renal dysfunction, using eGFR, proteinuria and cystatin C separately, with remote DWI lesions and total cSVD burden among the patients of primary ICH

Methods

Results

Conclusion