Abstract
The detrimental outcomes of white matter hyperintensity (WMH) are known to be proportional to WMH volume. This study aimed to evaluate the association between kidney dysfunction and white matter hyperintensity (WMH) volume. A total of 2,203 subjects who underwent brain magnetic resonance imaging (MRI) as part of a screening health check-up was included in this study. WMH was defined as hyperintensity signals without cavity formation in the white matter on fluid-attenuated inversion recovery images. WMH volume was measured quantitatively, and data were normalized by square root transformation prior to analysis. Mean age of the subjects was 56.9 years and mean WMH volume was 2.7 cm3. Mean estimated glomerular filtration rate (eGFR) level was 78.0 ml/min/1.73 m2, and 172 subjects (7.8%) were diagnosed with moderate-to-severe kidney dysfunction (eGFR < 60). Mean Urine albumin-to-creatinine ratio (UACR) was 0.02, and 166 subjects showed significant albuminuria (UACR ≥ 0.03). Multivariate analyses showed that each of UACR, significant albuminuria, and moderate-to-severe kidney dysfunction was significantly associated with increased WMH volume (all p < 0.05). When we considered significant albuminuria and moderate-to-severe kidney dysfunction simultaneously, subjects with both significant albuminuria and moderate-to-severe kidney dysfunction had more than twice the WMH volume as did those in the other groups (all p < 0.05). Kidney dysfunction, defined by albuminuria and eGFR, was independently associated with WMH volume. Risk factors related to WMH and its detrimental outcomes should be strictly modified in subjects with kidney dysfunction, especially in those with both albuminuria and a reduced eGFR.
Highlights
Www.nature.com/scientificreports quantitative volumetric assessment is critical in evaluating the association between markers for kidney dysfunction and white matter hyperintensity (WMH)
This study aimed to assess the association between kidney dysfunction, as defined by urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate, and quantitative WMH volume, as measured by a semi-automated technique
We found that the following factors were significantly associated with a change in WMH volume: age, smoking habit, taking anti-hypertensive, anti-diabetic, anti-dyslipidemic drugs, anti-coagulation/anti-platelet drugs, systolic and diastolic blood pressure, estimated glomerular filtration rate (eGFR), UACR, total cholesterol, low density lipoprotein, serum hemoglobin A1c level, hypertension, and diabetes (Table 2)
Summary
Www.nature.com/scientificreports quantitative volumetric assessment is critical in evaluating the association between markers for kidney dysfunction and WMH. In addition to the shortage of studies targeting the association between kidney dysfunction and WMH volume, the volumetric complexity and characteristics of WMH itself can cause methodological limitations, such as using the WMH grade instead of volume itself[7,8], and the inappropriate treatment of a zero value for WMH volume during logarithmic transformation[9,10]. This study aimed to assess the association between kidney dysfunction, as defined by urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and quantitative WMH volume, as measured by a semi-automated technique
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