Intracranial Dilative Arteriopathy Is Associated with Chronic Kidney Disease and Small Vessel Diseases in the Elderly

Objective

We sought to determine the responsible factors and clinical significance of dilatation of the internal carotid artery (ICA) and basilar artery (BA).

Methods

ICA and BA diameters were measured using magnetic resonance imaging (MRI) and their association with age, sex, conventional atherosclerotic factors, and estimated glomerular filtration rate (eGFR) were evaluated in 175 outpatients aged 40 to 89 years. The arterial diameters were measured as the maximal width of the flow void on T2-weighted MRI around the brainstem. The relationship between the arterial diameters and deep white matter hyperintensities (DWMHs) on MRI graded from 0 to 3 was also examined. Comparisons were performed between groups with diameters smaller and larger than the mean value for younger (40-69 years) and older (70-89 years) patients, and multiple regression analysis was conducted.

Results

Age differed significantly between the larger- and smaller-diameter groups in younger patients, but not in older patients. The larger-diameter group of older patients had a significantly lower eGFR (P = .0002 for ICA, P = .0035 for BA) and a higher DWMH grade (P = .0021 for ICA, P < .0001 for BA) compared to the smaller-diameter group. In multiple regression analysis adjusted for age and sex, a lower eGFR was an independent factor associated with larger arterial diameters (P = .0002 for ICA, P = .0021 for BA).

Conclusion

Kidney dysfunction is an independent factor that is related to ICA and BA dilatation, which is also associated with DWMHs that reflect small vessel diseases in older patients.

Key Words: Dilative arteriopathy, chronic kidney disease, deep white matter hyperintensity