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Neurological Sciences

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01-11-2020 | Cerebral Small Vessel Disease | Original Article

Relationship between white matter hyperintensities and chronic kidney disease in patients with acute lacunar stroke

Authors: Lei Yang, Ling Yu, Youqi Kong, Xiaoyu Zhang, Yue Li, Shuna Yang, Hua Gu, Shan Gao, Wenli Hu

Published in: Neurological Sciences | Issue 11/2020

Abstract

Background and purpose

Previous studies have revealed a relationship between chronic kidney disease (CKD) and white matter hyperintensities (WMH). However, studies on the WMH and CKD in acute stroke patients are rare, and the conclusion is consistent. Our study aimed to investigate the relationship between the severity of WMH and CKD in acute lacunar infarction patients.

Methods

Consecutive acute lacunar infarction patients were recruited in this cross-sectional study. All patients were divided into two groups according to the severity of periventricular WMH (PVWMH) and deep WMH (DWMH). We dichotomized the severity of WMH (PVWMH and DWMH, separately) into mild group (Fazekas scores 0–1) and moderate-severe group (Fazekas scores 2–3). Estimated glomerular filtration rate (eGFR), proteinuria, vascular risk factors, and clinical features were compared between these two groups. Multivariable logistic regression analysis was used to investigate the association between the severity of WMH and risk factors.

Results

A total of 993 acute lacunar infarction patients aged 25–95 years were enrolled. The proportions of participants presenting moderate-severe group PVWMH and DWMH were 46.6% and 38.6%, respectively. Patients with moderate-severe PVWMH had higher age (P < 0.001) and higher incidence of stroke history (P < 0.001) than those in mild group. The level of serum creatinine and the presence of CKD were significantly higher while the eGFR was significantly lower in patients with moderate-severe PVWMH than those with mild PVWMH. Patients with moderate-severe DWMH (n = 383) also had higher age (P < 0.001) and often had a history of stroke (P < 0.001). But the association between the severity of DWMH and eGFR was not found. Multivariable logistic regression analyses showed stage 2 CKD and stage 3 CKD were independently associated with moderate-severe PVWMH, but not DWMH.

Conclusions

Our study demonstrates that CKD was independently associated with moderate-severe PVWMH in patients with acute lacunar infarction, but not DWMH. PVWMH and DWMH may have distinct pathophysiology.

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Title: Relationship between white matter hyperintensities and chronic kidney disease in patients with acute lacunar stroke
Authors: Lei Yang
Ling Yu
Youqi Kong
Xiaoyu Zhang
Yue Li
Shuna Yang
Hua Gu
Shan Gao
Wenli Hu
Publication date: 01-11-2020
Publisher: Springer International Publishing
Keywords: Cerebral Small Vessel Disease
Stroke
Chronic Kidney Disease
Published in: Neurological Sciences / Issue 11/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-020-04397-3

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Springer Medicine

Relationship between white matter hyperintensities and chronic kidney disease in patients with acute lacunar stroke

Abstract

Background and purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Methods

Results

Conclusions

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