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Chronic kidney disease and its association with cerebral small vessel disease in the general older hypertensive population

Månsson, Tomas LU ; Rosso, Aldana LU ; Ellström, Katarina LU ; Abul-Kasim, Kasim LU and Elmståhl, Sölve LU (2024) In BMC Nephrology 25(1).
Abstract
Background
Cerebral small vessel disease can be identified using magnetic resonance imaging, and includes white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Cerebral small vessel disease and chronic kidney disease share many risk factors, including hypertension. This study aims to explore an association between chronic kidney disease and cerebral small vessel disease, and also to explore the role of hypertension in this relationship.
Methods
With a cross sectional study design, data from 390 older adults was retrieved from the general population study Good Aging in Skåne. Chronic kidney disease was defined as glomerular filtration rate < 60 ml/min/1,73m2. Associations between chronic... (More)
Background
Cerebral small vessel disease can be identified using magnetic resonance imaging, and includes white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Cerebral small vessel disease and chronic kidney disease share many risk factors, including hypertension. This study aims to explore an association between chronic kidney disease and cerebral small vessel disease, and also to explore the role of hypertension in this relationship.
Methods
With a cross sectional study design, data from 390 older adults was retrieved from the general population study Good Aging in Skåne. Chronic kidney disease was defined as glomerular filtration rate < 60 ml/min/1,73m2. Associations between chronic kidney disease and magnetic resonance imaging markers of cerebral small vessel disease were explored using logistic regression models adjusted for age and sex. In a secondary analysis, the same calculations were performed with the study sample stratified based on hypertension status.
Results
In the whole group, adjusted for age and sex, chronic kidney disease was not associated with any markers of cerebral small vessel disease. After stratification by hypertension status and adjusted for age and sex, we observed that chronic kidney disease was associated with cerebral microbleeds (OR 1.93, CI 1.04–3.59, p-value 0.037), as well as with cortical atrophy (OR 2.45, CI 1.34–4.48, p-value 0.004) only in the hypertensive group. In the non-hypertensive group, no associations were observed.
Conclusions
In this exploratory cross-sectional study, we observed that chronic kidney disease was associated with markers of cerebral small vessel disease only in the hypertensive subgroup of a general population of older adults. This might indicate that hypertension is an important link between chronic kidney disease and cerebral small vessel disease. Further studies investigating the relationship between CKD, CSVD, and hypertension are warranted. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Nephrology
volume
25
issue
1
article number
93
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85187759115
ISSN
1471-2369
DOI
10.1186/s12882-024-03528-8
language
English
LU publication?
yes
id
258b4de7-8b82-43a3-87dd-32aff32315ca
date added to LUP
2024-03-13 19:43:11
date last changed
2024-04-03 10:10:36
@article{258b4de7-8b82-43a3-87dd-32aff32315ca,
  abstract     = {{Background<br/>Cerebral small vessel disease can be identified using magnetic resonance imaging, and includes white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Cerebral small vessel disease and chronic kidney disease share many risk factors, including hypertension. This study aims to explore an association between chronic kidney disease and cerebral small vessel disease, and also to explore the role of hypertension in this relationship.<br/>Methods<br/>With a cross sectional study design, data from 390 older adults was retrieved from the general population study Good Aging in Skåne. Chronic kidney disease was defined as glomerular filtration rate &lt; 60 ml/min/1,73m2. Associations between chronic kidney disease and magnetic resonance imaging markers of cerebral small vessel disease were explored using logistic regression models adjusted for age and sex. In a secondary analysis, the same calculations were performed with the study sample stratified based on hypertension status.<br/>Results<br/>In the whole group, adjusted for age and sex, chronic kidney disease was not associated with any markers of cerebral small vessel disease. After stratification by hypertension status and adjusted for age and sex, we observed that chronic kidney disease was associated with cerebral microbleeds (OR 1.93, CI 1.04–3.59, p-value 0.037), as well as with cortical atrophy (OR 2.45, CI 1.34–4.48, p-value 0.004) only in the hypertensive group. In the non-hypertensive group, no associations were observed.<br/>Conclusions<br/>In this exploratory cross-sectional study, we observed that chronic kidney disease was associated with markers of cerebral small vessel disease only in the hypertensive subgroup of a general population of older adults. This might indicate that hypertension is an important link between chronic kidney disease and cerebral small vessel disease. Further studies investigating the relationship between CKD, CSVD, and hypertension are warranted.}},
  author       = {{Månsson, Tomas and Rosso, Aldana and Ellström, Katarina and Abul-Kasim, Kasim and Elmståhl, Sölve}},
  issn         = {{1471-2369}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Nephrology}},
  title        = {{Chronic kidney disease and its association with cerebral small vessel disease in the general older hypertensive population}},
  url          = {{http://dx.doi.org/10.1186/s12882-024-03528-8}},
  doi          = {{10.1186/s12882-024-03528-8}},
  volume       = {{25}},
  year         = {{2024}},
}