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, Stella Kidwell

Research output: Contribution to journalArticle

48 Citations (Scopus)

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
Externally publishedYes

Fingerprint

Cerebral Hemorrhage
Chronic Renal Insufficiency
Confidence Intervals
Odds Ratio
Glomerular Filtration Rate
Observational Studies

Keywords

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

ASJC Scopus subject areas

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

Cite this

Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage. / Ovbiagele, Bruce; Wing, Jeffrey J.; Menon, Ravi S.; Burgess, Richard E.; Gibbons, M. Christopher; Sobotka, Ian; German, Laura; Shara, Nawar M.; Fernandez, Stephen; Jayam-Trouth, Annapurni; Edwards, Dorothy Farrar; Kidwell, Stella.

In: Stroke, Vol. 44, No. 9, 09.2013, p. 2409-2413.

Research output: Contribution to journalArticle

Ovbiagele, B, Wing, JJ, Menon, RS, Burgess, RE, Gibbons, MC, Sobotka, I, German, L, Shara, NM, Fernandez, S, Jayam-Trouth, A, Edwards, DF & Kidwell, S 2013, 'Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage', Stroke, vol. 44, no. 9, pp. 2409-2413. https://doi.org/10.1161/STROKEAHA.113.001958
Ovbiagele, Bruce ; Wing, Jeffrey J. ; Menon, Ravi S. ; Burgess, Richard E. ; Gibbons, M. Christopher ; Sobotka, Ian ; German, Laura ; Shara, Nawar M. ; Fernandez, Stephen ; Jayam-Trouth, Annapurni ; Edwards, Dorothy Farrar ; Kidwell, Stella. / Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage. In: Stroke. 2013 ; Vol. 44, No. 9. pp. 2409-2413.
@article{91861fd3bd2844618ee825b66985d064,
title = "Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage",
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.",
keywords = "Antihypertensive therapy, Black, Cerebral hemorrhage, Cerebral microbleeds, Chronic, Hemorrhagic stroke, MRI, Prevalence, Renal, Renal insufficiency, Renin-angiotensin, Stroke",
author = "Bruce Ovbiagele and Wing, {Jeffrey J.} and Menon, {Ravi S.} and Burgess, {Richard E.} and Gibbons, {M. Christopher} and Ian Sobotka and Laura German and Shara, {Nawar M.} and Stephen Fernandez and Annapurni Jayam-Trouth and Edwards, {Dorothy Farrar} and Stella Kidwell",
year = "2013",
month = "9",
doi = "10.1161/STROKEAHA.113.001958",
language = "English (US)",
volume = "44",
pages = "2409--2413",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Association of chronic kidney disease with cerebral microbleeds in patients with primary intracerebral hemorrhage

AU - Ovbiagele, Bruce

AU - Wing, Jeffrey J.

AU - Menon, Ravi S.

AU - Burgess, Richard E.

AU - Gibbons, M. Christopher

AU - Sobotka, Ian

AU - German, Laura

AU - Shara, Nawar M.

AU - Fernandez, Stephen

AU - Jayam-Trouth, Annapurni

AU - Edwards, Dorothy Farrar

AU - Kidwell, Stella

PY - 2013/9

Y1 - 2013/9

N2 - 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.

AB - 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.

KW - Antihypertensive therapy

KW - Black

KW - Cerebral hemorrhage

KW - Cerebral microbleeds

KW - Chronic

KW - Hemorrhagic stroke

KW - MRI

KW - Prevalence

KW - Renal

KW - Renal insufficiency

KW - Renin-angiotensin

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=84884478913&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884478913&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.113.001958

DO - 10.1161/STROKEAHA.113.001958

M3 - Article

C2 - 23847251

AN - SCOPUS:84884478913

VL - 44

SP - 2409

EP - 2413

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 9

ER -