Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: the Ohasama study
| Autor: | Hirohito Metoki, Kazuhito Totsune, Yutaka Imai, Hiroyuki Terawaki, Taku Obara, Azusa Hara, Haruhisa Hoshi, Masahiro Kikuya, Masaaki Nakayama, Shiho Terata, Atsuhiro Kanno, Takeo Kondo, Harunori Otani, Shin-ichi Izumi, Takayoshi Ohkubo, Kei Asayama, Ryusuke Inoue, Hiroshi Satoh, Takuo Hirose |
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| Rok vydání: | 2009 |
| Předmět: |
Brain Infarction
Male medicine.medical_specialty Pathology Ambulatory blood pressure Population Blood Pressure Kidney behavioral disciplines and activities Risk Assessment Asian People Japan Risk Factors Internal medicine mental disorders Odds Ratio Prevalence Medicine Humans cardiovascular diseases education Aged education.field_of_study Chi-Square Distribution business.industry Kidney dysfunction Age Factors Brain Blood Pressure Monitoring Ambulatory Middle Aged Magnetic Resonance Imaging Hyperintensity nervous system diseases Lacunar Infarcts Cross-Sectional Studies Logistic Models Neurology White matter hyperintensity Creatinine Ambulatory Cardiology Female Kidney Diseases Neurology (clinical) Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Cerebrovascular diseases (Basel, Switzerland). 30(1) |
| ISSN: | 1421-9786 |
| Popis: | Background: No previous study has investigated the association of kidney dysfunction with silent lacunar infarcts and white-matter hyperintensity (WMH) independent of ambulatory blood pressure (BP). Methods: A cross-sectional study involving 1,008 participants (mean age 66 years) from a general population of Ohasama, Japan, was conducted. Calculated creatinine clearance (CCr) was estimated using the Cockcroft-Gault equation. In continuous and categorical analyses, the association between CCr and the prevalence of silent lacunar infarcts and WMH was investigated. Silent lacunar infarcts and WMH were detected on MRI. Multiple logistic regression analysis adjusted for 24-hour ambulatory BP, sex, age, body mass index, smoking and drinking status, antihypertensive medication, and histories of hypercholesterolemia, diabetes mellitus and heart disease was performed. Results: On univariate analysis, decreased CCr (continuous variable) and CCr 2 (categorical variable) were significantly associated with lacunar infarcts and WMH. After adjustment, each 1-standard-deviation decrease in CCr (odds ratio = 1.22; p = 0.036) and CCr 2 (odds ratio = 1.68; p = 0.007) was significantly associated with a high prevalence of lacunar infarcts. Even when 24-hour ambulatory BP was within the normal range (2 was associated with a high prevalence of lacunar infarcts (odds ratio = 1.62; p = 0.047). CCr 2 and 24-hour ambulatory BP had additive effects on lacunar infarcts. After the same adjustment, the association between CCr and WMH was not significant. Conclusions: CCr is closely associated with lacunar infarcts, suggesting that kidney dysfunction in the elderly is an independent risk factor or predictor for silent lacunar infarcts. |
| Databáze: | OpenAIRE |
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