Document Detail


Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: the Ohasama study.
MedLine Citation:
PMID:  20431289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 m(2) (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 m(2) (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 m(2) 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.
Authors:
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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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-29
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  30     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  43-50     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Asian Continental Ancestry Group
Biological Markers / blood
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Brain / pathology*
Brain Infarction / ethnology,  etiology*,  pathology,  physiopathology
Chi-Square Distribution
Creatinine / blood
Cross-Sectional Studies
Female
Humans
Japan / epidemiology
Kidney / physiopathology*
Kidney Diseases / complications*,  ethnology,  physiopathology
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Odds Ratio
Prevalence
Risk Assessment
Risk Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 60-27-5/Creatinine

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