Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage

Bruce Ovbiagele, Jeffrey J. Wing, Ravi S. Menon, Richard E. Burgess, M. Christopher Gibbons, Ian Sobotka, Laura German, Nawar M. Shara, Stephen Fernandez, Annapurni Jayam-Trouth, Dorothy Farrar Edwards, Chelsea S. Kidwell

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Background and Purpose - To investigate the relationship between chronic kidney disease (CKD) and MRI-defined cerebral microbleeds (CMB), a harbinger of future intracerebral hemorrhage (ICH), among patients with a recent history of primary ICH. Methods - Using data from a predominantly black cohort of patients with a recent ICH-enrolled in an observational study between September 2007 and June 2011, we evaluated the association between CKD (defined as estimated low glomerular filtration rate<60 mL/min per 1.73 m2) and CMB on gradient-echo MRI. Multivariable models were generated to determine the contribution of CKD to the presence, number, and location of CMB. Results - Of 197 subjects with imaging data, mean age was 59 years, 48% were women, 73% were black, 114 (58%) had ≥1 CMBs, and 52 (26%) had CKD. Overall, CKD was associated with presence of CMB (adjusted odds ratio, 2.70; 95% confidence interval [CI], 1.10-6.59) and number of CMB (adjusted relative risk, 2.04; 95% CI, 1.27-3.27). CKD was associated with CMB presence (adjusted odds ratio, 3.44; 95% CI, 1.64-7.24) and number (adjusted relative risk, 2.46; 95% CI, 1.11-5.42) in black patients, but not CMB presence (adjusted odds ratio, 3.00; 95% CI, 0.61-14.86) or number (adjusted relative risk, 1.03; 95% CI: 0.22-4.89) in non-Hispanic white patients (interactions by race were statistically not significant). Conclusions - CKD is associated with a greater presence and number of CMB in ICH patients, particularly in patients of black race. Future studies should assess whether low estimated glomerular filtration rate may be a CMB risk marker or potential therapeutic target for mitigating the development of CMB.

Original languageEnglish (US)
Pages (from-to)2409-2413
Number of pages5
JournalStroke
Volume44
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Antihypertensive therapy
  • Black
  • Cerebral hemorrhage
  • Cerebral microbleeds
  • Chronic
  • Hemorrhagic stroke
  • MRI
  • Prevalence
  • Renal
  • Renal insufficiency
  • Renin-angiotensin
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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