Background
Cerebral small-vessel disease (SVD) is associated with renal dysfunction such as chronic
kidney disease. Although cerebral microbleeds (CMBs) are common in patients with acute
lacunar infarcts (ALI), the association between renal dysfunction and CMBs in such
patients remains unclear.
Methods
Between April 2007 and March 2013, we evaluated consecutive first-ever ALI patients,
who were admitted to our hospital within 24 hours of stroke onset. CMBs were defined
as focal areas of signal loss in brain parenchyma less than 5 mm on T2∗-weighted gradient-echo imaging. Renal dysfunction was defined as an estimated glomerular
filtration rate less than 60 mL/minute/1.73 m2 on admission. Correlations between renal dysfunction and the presence (model 1) and
location of CMBs (model 2; any deep or infratentorial CMBs) were determined by multivariable
logistic regression analyses.
Results
Among 152 patients (33.6% men; mean age, 67.6 years), 53 had CMBs. Patients with CMBs
were older (69.9 versus 66.3 years, P = .03) and had a higher frequency of white matter hyperintensity (WMH; 62.3% versus
25.3%, P < .001), silent lacunar infarcts (SLI; 75.5% versus 43.3%, P < .001), and renal dysfunction (41.5% versus 22.2%, P = .015) than those without CMBs. On multivariable analyses, renal dysfunction (odds
ratio, 95% confidence interval; model 1: 2.38, 1.02-5.66; model 2: 2.78, 1.16-6.81),
WMH (3.87, 1.76-8.80; 3.72, 1.64-8.71), SLI (3.85, 1.71-9.14; 4.20, 1.77-10.8), and
diabetes mellitus (.26, .09-.63; .24, .08-.63) were independently associated with
CMBs.
Conclusions
In patients with ALI, renal dysfunction was positively associated with CMBs independent
of cerebral SVD.
Key Words
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Article info
Publication history
Published online: August 28, 2015
Accepted:
July 12,
2015
Received in revised form:
July 3,
2015
Received:
June 3,
2015
Footnotes
N.S. reports a research grant, Grants-in-Aid for Scientific Research (No. 26870765) from the Japan Society for the Promotion of Science.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.010
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
