Cerebral microbleeds in predialysis patients with chronic kidney disease

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Neuron 1998; 21: 1327–1337 Received for publication: 9.4.09; Accepted in revised form: 13.11.09 Nephrol Dial Transplant (2010) 25: 1554–1559 doi: 10.1093/ndt/gfp694 Advance Access publication 27 December 2009 Cerebral microbleeds in predialysis patients with chronic kidney disease Hideaki Shima1, Eiji Ishimura2, Toshihide Naganuma3, Takeshi Yamazaki3, Ikue Kobayashi1, Kaori Shidara1, Katsuhito Mori1, Yoshiaki Takemoto3, Tetsuo Shoji1, Masaaki Inaba1, Mikio Okamura4, Tatsuya Nakatani3 and Yoshiki Nishizawa1 1 Department of Endocrinology, Metabolism and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan, 2Department of Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan, 3Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan and 4Ohno Memorial Hospital, Osaka, Japan Correspondence and offprint requests to: Eiji Ishimura; E-mail: Abstract Background. Gradient-echo T2*-weighted magnetic resonance imaging (T2*-weighted MRI) is highly sensitive for detecting cerebral microbleeds (CMBs). CMBs have been reported to be a risk factor for future cerebrovascular events and a marker of cerebral small vessel disease in the general © The Author 2009. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: 2. Rekola S, Bergstrand A, Bucht H. Deterioration of GFR in IgA nephropathy as measured by 51Cr-EDTA clearance. Kidney Int 1991; 40: 1050–1054 3. Koyama A, Igarashi M, Kobayashi M. Natural history and risk factors for immunoglobulin A nephropathy in Japan. Research Group on Progressive Renal Diseases. Am J Kidney Dis 1997; 29: 526–532 4. Geddes CC, Rauta V, Gronhagen-Riska C et al. A tricontinental view of IgA nephropathy. Nephrol Dial Transplant 2003; 18: 1541–1548 5. Hsu SI, Ramirez SB, Winn MP et al. Evidence for genetic factors in the development and progression of IgA nephropathy. 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Genome-wide linkage scan of a large family with IgA nephropathy localizes a novel susceptibility locus to chromosome 2q36. J Am Soc Nephrol 2007; 18: 2408–2415 12. The Wellcome Trust Case Control Consortium. Genome-wide association study of 14, 000 cases of seven common diseases and 3,000 shared controls. Nature 2007; 447: 661–678 13. Ohtsubo S, Iida A, Nitta K et al. Association of a single-nucleotide polymorphism in the immunoglobulin mu-binding protein 2 gene with immunoglobulin A nephropathy. J Hum Genet 2005; 50: 30–35 14. Li YJ, Du Y, Li CX et al. Family-based association study showing that immunoglobulin A nephropathy is associated with the poly- H. Shima et al. Cerebral microbleeds in predialysis patients with chronic kidney disease 1555 population. Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. The relationship between CKD and CMBs, which has not been clarified to date, is examined. Methods. In this cross-sectional study, T2*-weighted MRI of brain was performed with a 1.5-T MRI system in 162 CKD patients (CKD stages 1–5, excluding CKD stage 5 (D)) and 24 normal subjects. Results. CMBs were found in 35 CKD patients (25.6%), but not in control subjects. CMBs were more prevalent in male patients, in those with higher blood pressure, advanced age and poor kidney function. There was a significant association between the prevalence of CMBs and the CKD stage, with higher prevalence of CMBs as the CKD stages advanced (P < 0.01). Estimated glomerular filtration rate was a significant factor associated with the prevalence of CMBs, independent of age, gender and hypertension. There was no significant relationship between CMBs and the presence of diabetes mellitus and dyslipidemia. Conclusions. Decreased renal function is a significant risk factor for CMBs, independent of the presence of hypertension. Poor kidney function could be associated with future cerebrovascular events. [16,17,19]. In haemodialysis patients, there is a significantly higher prevalence of CMBs compared with normal subjects [20,21]. However, there have been no reports on the prevalence of CMBs in CKD patients without dialysis therapy. In the present stu (...truncated)