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Article: Age-Specific Associations of Renal Impairment and Cerebral Small Vessel Disease Burden in Chinese with Ischaemic Stroke

TitleAge-Specific Associations of Renal Impairment and Cerebral Small Vessel Disease Burden in Chinese with Ischaemic Stroke
Authors
KeywordsCerebral small vessel disease
Chronic kidney disease
Magnetic
Resonance imaging
Renal impairment
Issue Date2019
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jstroke
Citation
Journal of Stroke & Cerebrovascular Diseases, 2019, v. 28 n. 5, p. 1274-1280 How to Cite?
AbstractBackground: Recent studies in Caucasians with transient ischaemic attack or ischaemic stroke have demonstrated significant age-specific associations between cerebral small vessel disease (SVD) burden on magnetic resonance imaging and renal impairment. We aimed to validate these findings in a large cohort of Chinese with ischaemic stroke. Methods: In 959 Chinese with ischaemic stroke who received a brain magnetic resonance imaging at the University of Hong Kong, we determined the age-specific associations of renal impairment (glomerular filtration rate < 60 mL/min/1.73 m2) with neuroimaging markers of SVD as well as with the SVD score. Results: Although renal impairment was associated with the SVD score in univariate analysis in all patients (odds ratio 1.61, 95% confidence interval 1.24-2.09, P < .0001), these associations were attenuated after adjusting for age and sex (P = .38). Similar findings were noted in patients with ischaemic stroke due to SVD and non-SVD subtypes. However, in 222 of 959 patients aged <60, renal impairment was independently associated with an increasing microbleed (adjusted odds ratio 6.82, 2.26-20.59), subcortical (4.97, 1.62-15.24) periventricular white matter hyperintensity (3.96, 1.08-14.51) and global SVD burden (3.41, 1.16-10.04; all P < .05) even after adjusting for age, sex, and vascular risk factors. Nevertheless, there were no associations between renal impairment and individual neuroimaging markers of SVD nor with the SVD score in patients aged ≥60 after adjusting for age and sex (all P > .05). Conclusions: In Chinese with ischaemic stroke, renal impairment was independently associated with microbleed, white matter hyperintensity and global SVD burden in individuals aged <60, but not in those aged ≥60, suggesting that there may be shared susceptibilities to premature systemic disease.
Persistent Identifierhttp://hdl.handle.net/10722/272883
ISSN
2017 Impact Factor: 1.598
2015 SCImago Journal Rankings: 0.794

 

DC FieldValueLanguage
dc.contributor.authorLau, GK-
dc.contributor.authorTsang, ACO-
dc.contributor.authorTeo, KC-
dc.contributor.authorLi, HL-
dc.contributor.authorChu, LKW-
dc.contributor.authorLi, JCH-
dc.contributor.authorChan, MKC-
dc.contributor.authorWan, VHL-
dc.contributor.authorHui, ES-
dc.contributor.authorMak, HKF-
dc.date.accessioned2019-08-06T09:18:22Z-
dc.date.available2019-08-06T09:18:22Z-
dc.date.issued2019-
dc.identifier.citationJournal of Stroke & Cerebrovascular Diseases, 2019, v. 28 n. 5, p. 1274-1280-
dc.identifier.issn1052-3057-
dc.identifier.urihttp://hdl.handle.net/10722/272883-
dc.description.abstractBackground: Recent studies in Caucasians with transient ischaemic attack or ischaemic stroke have demonstrated significant age-specific associations between cerebral small vessel disease (SVD) burden on magnetic resonance imaging and renal impairment. We aimed to validate these findings in a large cohort of Chinese with ischaemic stroke. Methods: In 959 Chinese with ischaemic stroke who received a brain magnetic resonance imaging at the University of Hong Kong, we determined the age-specific associations of renal impairment (glomerular filtration rate < 60 mL/min/1.73 m2) with neuroimaging markers of SVD as well as with the SVD score. Results: Although renal impairment was associated with the SVD score in univariate analysis in all patients (odds ratio 1.61, 95% confidence interval 1.24-2.09, P < .0001), these associations were attenuated after adjusting for age and sex (P = .38). Similar findings were noted in patients with ischaemic stroke due to SVD and non-SVD subtypes. However, in 222 of 959 patients aged <60, renal impairment was independently associated with an increasing microbleed (adjusted odds ratio 6.82, 2.26-20.59), subcortical (4.97, 1.62-15.24) periventricular white matter hyperintensity (3.96, 1.08-14.51) and global SVD burden (3.41, 1.16-10.04; all P < .05) even after adjusting for age, sex, and vascular risk factors. Nevertheless, there were no associations between renal impairment and individual neuroimaging markers of SVD nor with the SVD score in patients aged ≥60 after adjusting for age and sex (all P > .05). Conclusions: In Chinese with ischaemic stroke, renal impairment was independently associated with microbleed, white matter hyperintensity and global SVD burden in individuals aged <60, but not in those aged ≥60, suggesting that there may be shared susceptibilities to premature systemic disease.-
dc.languageeng-
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jstroke-
dc.relation.ispartofJournal of Stroke & Cerebrovascular Diseases-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCerebral small vessel disease-
dc.subjectChronic kidney disease-
dc.subjectMagnetic-
dc.subjectResonance imaging-
dc.subjectRenal impairment-
dc.titleAge-Specific Associations of Renal Impairment and Cerebral Small Vessel Disease Burden in Chinese with Ischaemic Stroke-
dc.typeArticle-
dc.identifier.emailLau, GK: gkklau@hku.hk-
dc.identifier.emailTsang, ACO: acotsang@hku.hk-
dc.identifier.emailTeo, KC: tkc299@hku.hk-
dc.identifier.emailHui, ES: edshui@hku.hk-
dc.identifier.emailMak, HKF: makkf@hku.hk-
dc.identifier.authorityLau, GK=rp01499-
dc.identifier.authorityTsang, ACO=rp01519-
dc.identifier.authorityHui, ES=rp01832-
dc.identifier.authorityMak, HKF=rp00533-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2019.01.018-
dc.identifier.pmid30853188-
dc.identifier.scopuseid_2-s2.0-85062463367-
dc.identifier.hkuros299644-
dc.identifier.volume28-
dc.identifier.issue5-
dc.identifier.spage1274-
dc.identifier.epage1280-
dc.publisher.placeUnited States-

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