Abstract WP196: Chronic Kidney Disease and the Burden of Microvascular Brain Damage
Introduction: chronic kidney disease (CKD) coexists with microvascular brain damage. This cerebrorenal connection is considered to involve small vessel disease in both the kidney and brain, based on their hemodynamic similarities.
Hypothesis: to evaluate the relationship between microvascular brain damage (white matter hyperintensities -WMH-, microbleeds -MB- and silent brain infarcts -SBI-), and glomerular filtration rate (GFR) in a cohort of ischemic stroke patients.
Methods: patients were prospectively included in a multidisciplinary secondary stroke prevention program. Pre-stroke vascular risk factor profile and control were obtained from electronic medical records and the burden of microvascular brain damage was evaluated on admission MRI. For the purpose of the analysis three groups were defined according to GFR estimated by Cockroft-Gault formula: >60, 30-60 and <30 ml/min/1.73 m2. Periventricular and deep WMH were classified according to Fazekas scale as low grade (0-1) and high grade (2-3); MB and SBI (lacunar and non-lacunar) were analyzed as dichotomous variables. Exclusion criteria: TIA and patients without MRI.
Results: 808 patients (mean age 77±11 years, 59% females) were included. GRF was inversely related to age (70±11, 83±6, 85±8 years; p 0.0001), female sex (48%, 69%, 66%; p 0.001), hypertension (76%, 89%, 91%; p 0.0001) and AF (16%, 21%, 34%; p 0.08) prevalence. Chronic microvascular brain damage burden was inversely related to e-GFR (table).
Conclusion: decreased GFR indicates small vessel disease not only in the kidney but also in the brain. As small vessel disease is a systemic disorder, information about disease in one organ may suggest damage in the other.
Author Disclosures: M.C. Zurru: None. C. Alonzo: None. L. Brescacín: None. P.E. Colla Machado: None. G. Linares: None. L. Camera: None. E. Cristiano: None. G. Waisman: None.
- © 2016 by American Heart Association, Inc.