J Clin Neurol.  2014 Jul;10(3):222-228. 10.3988/jcn.2014.10.3.222.

Distribution of Cerebral Microbleeds Determines Their Association with Impaired Kidney Function

• Song TJ
• Kim J
• Lee HS
• Nam CM
• Nam HS
• Kim YD
• Heo JH

• KMID: 2179449
• DOI: http://doi.org/10.3988/jcn.2014.10.3.222

Abstract

BACKGROUND AND PURPOSE
Cerebral microbleeds (CMBs) are associated with various pathologies of the cerebral small vessels according to their distribution (i.e., cerebral amyloid angiopathy or hypertensive angiopathy). We investigated the association between CMB location and kidney function in acute ischemic stroke patients.
METHODS
We enrolled 1669 consecutive patients with acute ischemic stroke who underwent gradient-recalled echo brain magnetic resonance imaging. Kidney function was determined using the estimated glomerular filtration rate (eGFR). CMBs were classified into strictly lobar, strictly nonlobar (i.e., only deep or infratentorial), and a combination of both lobar and nonlobar. Multinomial logistic regression analyses were used to determine the factors associated with the existence of CMBs according to their location.
RESULTS
The patients were aged 66+/-12 years (mean+/-standard deviation), and 61.9% (1033/1669) of them were male. CMBs were found in 27.0% (452/1669) of the patients. The stroke subtypes of small-artery occlusion and cardioembolism occurred more frequently in those with strictly nonlobar CMBs (10.8%) and strictly lobar CMBs (48.8%), respectively. The mean eGFR was lower in the strictly nonlobar CMBs group (72+/-28 mL/min/1.73 m2) and the both lobar and nonlobar CMBs group (72+/-25 mL/min/1.73 m2) than in the no-CMBs group (86+/-29 mL/min/1.73 m2). Multivariate multinomial logistic regression revealed that eGFR <60 mL/min/1.73 m2 was independently related to strictly nonlobar CMBs (odds ratio=2.63, p=0.001).
CONCLUSIONS
Impaired kidney function is associated with strictly nonlobar CMBs. Our findings indicate that the distribution of CMBs should be considered when evaluating their relationships or prognoses.

Keyword

cerebral microbleed; estimated glomerular filtration rate; chronic renal failure

MeSH Terms

Brain
Cerebral Amyloid Angiopathy
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic
Kidney*
Logistic Models
Magnetic Resonance Imaging
Male
Pathology
Prognosis
Stroke

Figure

• 

  Fig. 1 Representative images demonstrating the classification of cerebral microbleeds into (A) strictly lobar CMBs, (B) strictly nonlobar CMBs, and (C) both lobar and nonlobar CMBs. CMBs: cerebral microbleeds.

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