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Cerebral small vessel disease and chronic kidney disease.

Toyoda K - J Stroke (2015)

Bottom Line: The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity.Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors.Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.

ABSTRACT
Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small artery diseases, kidney impairment can be predictive of the presence and severity of cerebral small vessel diseases. Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors. In addition, chronic kidney disease affects cognitive function, partly via the high prevalence of cerebral small vessel diseases. Retinal artery disease also has an independent relationship with chronic kidney disease and cognitive impairment. Stroke experts are no longer allowed to be ignorant of chronic kidney disease. Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients.

No MeSH data available.


Related in: MedlinePlus

The prevalence of eGFR <60 mL/min/1.73 m2 in the general population and stroke patients.Orange bars indicate data from Japanese subjects.Mean age (years): [2] 70.1 (overall stroke), [7] 66, [8] 66.0, [9] 71.4, [10] 70.0, [11] 71.7, [12] 65.6, [13] 46.2, [14] 50.2. From reference 3 with permission.
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Figure 1: The prevalence of eGFR <60 mL/min/1.73 m2 in the general population and stroke patients.Orange bars indicate data from Japanese subjects.Mean age (years): [2] 70.1 (overall stroke), [7] 66, [8] 66.0, [9] 71.4, [10] 70.0, [11] 71.7, [12] 65.6, [13] 46.2, [14] 50.2. From reference 3 with permission.

Mentions: CKD is prevalent in stroke patients. Figure 1 shows the prevalence of eGFR below 60 mL/min/1.73 m2 in both the general population and acute stroke patients.3 For acute stroke patients, eGFR was assessed using creatinine levels during acute stroke and was accordingly affected by acute stroke damage. The prevalence varies from 20% to 35% in patients with acute ischemic stroke2,6,7,8,9,10 and from 20% to 46% in patients with acute intracerebral hemorrhage (ICH).2,6,11,12 This prevalence was found to be higher than that in the general population (4.4% to 11%) and similar to that in the elderly general population aged 70 years or older (19% to 38%).13,14,15 Stroke occurs much more commonly in dialysis patients than in the general population or CKD patients without need for dialysis. In my previous studies in a kidney center in the Fukuoka metropolitan area in western Japan, the incidence of total stroke for patients receiving hemodialysis was 13 per 1,000 person-years, and that for patients receiving continuous ambulatory peritoneal dialysis was 15.7 per 1000 person-years.16,17


Cerebral small vessel disease and chronic kidney disease.

Toyoda K - J Stroke (2015)

The prevalence of eGFR <60 mL/min/1.73 m2 in the general population and stroke patients.Orange bars indicate data from Japanese subjects.Mean age (years): [2] 70.1 (overall stroke), [7] 66, [8] 66.0, [9] 71.4, [10] 70.0, [11] 71.7, [12] 65.6, [13] 46.2, [14] 50.2. From reference 3 with permission.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325633&req=5

Figure 1: The prevalence of eGFR <60 mL/min/1.73 m2 in the general population and stroke patients.Orange bars indicate data from Japanese subjects.Mean age (years): [2] 70.1 (overall stroke), [7] 66, [8] 66.0, [9] 71.4, [10] 70.0, [11] 71.7, [12] 65.6, [13] 46.2, [14] 50.2. From reference 3 with permission.
Mentions: CKD is prevalent in stroke patients. Figure 1 shows the prevalence of eGFR below 60 mL/min/1.73 m2 in both the general population and acute stroke patients.3 For acute stroke patients, eGFR was assessed using creatinine levels during acute stroke and was accordingly affected by acute stroke damage. The prevalence varies from 20% to 35% in patients with acute ischemic stroke2,6,7,8,9,10 and from 20% to 46% in patients with acute intracerebral hemorrhage (ICH).2,6,11,12 This prevalence was found to be higher than that in the general population (4.4% to 11%) and similar to that in the elderly general population aged 70 years or older (19% to 38%).13,14,15 Stroke occurs much more commonly in dialysis patients than in the general population or CKD patients without need for dialysis. In my previous studies in a kidney center in the Fukuoka metropolitan area in western Japan, the incidence of total stroke for patients receiving hemodialysis was 13 per 1,000 person-years, and that for patients receiving continuous ambulatory peritoneal dialysis was 15.7 per 1000 person-years.16,17

Bottom Line: The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity.Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors.Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.

ABSTRACT
Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small artery diseases, kidney impairment can be predictive of the presence and severity of cerebral small vessel diseases. Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors. In addition, chronic kidney disease affects cognitive function, partly via the high prevalence of cerebral small vessel diseases. Retinal artery disease also has an independent relationship with chronic kidney disease and cognitive impairment. Stroke experts are no longer allowed to be ignorant of chronic kidney disease. Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients.

No MeSH data available.


Related in: MedlinePlus