Deterioration of Glomerular Filtration Rate is Associated With Greater Cerebral Small Vessel Disease Burden in Ischemic Stroke Patients Aged Below 80 Years.

Stroke(2019)

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摘要
Introduction: Cerebral small vessel disease (cSVD) and deterioration of glomerular filtration rate (dGFR) may be part of a systemic small vessel disease, or simply the consequence of vascular risk factors (VRF) and age related vessel changes. Objective: to assess the relation of cSVD burden and dGFR in ischemic stroke patients. Methods: acute ischemic stroke patients that had a brain MRI performed within 48 hours upon admission were enrrolled. Demographic data and vascular risk factores were analyzed. SVD score (Staals J et al, Neurology. 2014;83:1228-1234) was employed to evaluate cSVD burden in MRI. An univariate analysis was performed, and then a multivariate regression analysis which was adjusted by sex, vascular risk factors, and stratified by age. Results: Eight hundred and eight patients were included. Mean age was 77 ± 11 years, and 56% were female. In the univariate analysis (table 1), patients with SVD score ≥2 were older, had greater prevalence of VRF, and greater dGFR. In the unadjusted regression analysis, the global OR for heavier cSVD burden in patients with dGFR was 3 (CI 95% 1.8-3.2). When adjusted for sex, VRF, and stratified by age, the OR was 2.6 (IC 95% 1.88-3.10) in patients aged <65 years, 2.2 (IC 95% 1.77-3) in patients aged 65-79 years, and 0.72 (IC 95% 0.43-1.05) in patients aged over 80 years. Conclusions: The relation between dGFR and cSVD was attenuated in patients aged over 80 when adjusted for age and VRF prevalence. In patients aged ≤80 years, dGFR was associated with greater cSVD burden.
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Renal function,Silent brain infarction
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