Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: The Ohasama study

Harunori Otani, Masahiro Kikuya, Azusa Hara, Shiho Terata, Takayoshi Ohkubo, Takeo Kondo, Takuo Hirose, Taku Obara, Hirohito Metoki, Ryusuke Inoue, Kei Asayama, Atsuhiro Kanno, Hiroyuki Terawaki, Masaaki Nakayama, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Shin Ichi Izumi, Yutaka Imai

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Abstract

Background: No previous study has investigated the association of kidney dysfunction with silent lacunar infarcts and white-matter hyperintensity (WMH) independent of ambulatory blood pressure (BP). Methods: A cross-sectional study involving 1,008 participants (mean age 66 years) from a general population of Ohasama, Japan, was conducted. Calculated creatinine clearance (CCr) was estimated using the Cockcroft-Gault equation. In continuous and categorical analyses, the association between CCr and the prevalence of silent lacunar infarcts and WMH was investigated. Silent lacunar infarcts and WMH were detected on MRI. Multiple logistic regression analysis adjusted for 24-hour ambulatory BP, sex, age, body mass index, smoking and drinking status, antihypertensive medication, and histories of hypercholesterolemia, diabetes mellitus and heart disease was performed. Results: On univariate analysis, decreased CCr (continuous variable) and CCr <60 ml/min/1.73 m2 (categorical variable) were significantly associated with lacunar infarcts and WMH. After adjustment, each 1-standard-deviation decrease in CCr (odds ratio = 1.22; p = 0.036) and CCr <60 ml/min/1.73 m2 (odds ratio = 1.68; p = 0.007) was significantly associated with a high prevalence of lacunar infarcts. Even when 24-hour ambulatory BP was within the normal range (<130/80 mm Hg), CCr <60 ml/min/1.73 m2 was associated with a high prevalence of lacunar infarcts (odds ratio = 1.62; p = 0.047). CCr <60 ml/min/1.73 m 2 and 24-hour ambulatory BP had additive effects on lacunar infarcts. After the same adjustment, the association between CCr and WMH was not significant. Conclusions: CCr is closely associated with lacunar infarcts, suggesting that kidney dysfunction in the elderly is an independent risk factor or predictor for silent lacunar infarcts.

Original languageEnglish
Pages (from-to)43-50
Number of pages8
JournalCerebrovascular Diseases
Volume30
Issue number1
DOIs
Publication statusPublished - 2010 Jun

Keywords

  • Ambulatory blood pressure
  • Chronic kidney disease
  • General population
  • Lacunar infarcts
  • White-matter hyperintensity

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Otani, H., Kikuya, M., Hara, A., Terata, S., Ohkubo, T., Kondo, T., Hirose, T., Obara, T., Metoki, H., Inoue, R., Asayama, K., Kanno, A., Terawaki, H., Nakayama, M., Totsune, K., Hoshi, H., Satoh, H., Izumi, S. I., & Imai, Y. (2010). Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: The Ohasama study. Cerebrovascular Diseases, 30(1), 43-50. https://doi.org/10.1159/000313612