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肾功能与脑血流量:鹿特丹研究

Kidney Function and Cerebral Blood Flow: The Rotterdam Study.

作者信息

Sedaghat Sanaz, Vernooij Meike W, Loehrer Elizabeth, Mattace-Raso Francesco U S, Hofman Albert, van der Lugt Aad, Franco Oscar H, Dehghan Abbas, Ikram M Arfan

机构信息

Departments of Epidemiology.

Departments of Epidemiology, Radiology, and.

出版信息

J Am Soc Nephrol. 2016 Mar;27(3):715-21. doi: 10.1681/ASN.2014111118. Epub 2015 Aug 6.

Abstract

CKD is linked with various brain disorders. Whereas brain integrity is dependent on cerebral perfusion, the association between kidney function and cerebral blood flow has yet to be determined. This study was performed in the framework of the population-based Rotterdam Study and included 2645 participants with mean age of 56.6 years (45% men). We used eGFR and albumin-to-creatinine ratio to assess kidney function and performed phase-contrast magnetic resonance imaging of basilar and carotid arteries to measure cerebral blood flow. Participants had an average (SD) eGFR of 86.3 (13.4) ml/min per 1.73 m(2) and a median (interquartile range) albumin-to-creatinine ratio of 3.4 (2.2-6.1) mg/g. In age- and sex-adjusted models, a higher albumin-to-creatinine ratio was associated with lower cerebral blood flow level (difference in cerebral blood flow [milliliters per minute per 100 ml] per doubling of the albumin-to-creatinine ratio, -0.31; 95% confidence interval, -0.58 to -0.03). The association was not present after adjustment for cardiovascular risk factors (P=0.10). Each 1 SD lower eGFR was associated with 0.42 ml/min per 100 ml lower cerebral blood flow (95% confidence interval, 0.01 to 0.83) adjusted for cardiovascular risk factors. Thus, in this population-based study, we observed that lower eGFR is independently associated with lower cerebral blood flow.

摘要

慢性肾脏病(CKD)与多种脑部疾病相关。鉴于脑完整性依赖于脑灌注,肾功能与脑血流之间的关联尚未确定。本研究是在基于人群的鹿特丹研究框架内进行的,纳入了2645名参与者,平均年龄为56.6岁(45%为男性)。我们使用估算肾小球滤过率(eGFR)和白蛋白与肌酐比值来评估肾功能,并对基底动脉和颈动脉进行相位对比磁共振成像以测量脑血流。参与者的平均(标准差)eGFR为每1.73平方米86.3(13.4)毫升/分钟・1.73平方米,白蛋白与肌酐比值的中位数(四分位间距)为3.4(2.2 - 6.1)毫克/克。在年龄和性别调整模型中,较高的白蛋白与肌酐比值与较低的脑血流水平相关(白蛋白与肌酐比值每增加一倍,脑血流[每分钟每100毫升的毫升数]的差异为 -0.31;95%置信区间为 -0.58至 -0.03)。在调整心血管危险因素后,这种关联不再存在(P = 0.10)。在调整心血管危险因素后,eGFR每降低1个标准差,脑血流每分钟每100毫升降低0.42毫升(95%置信区间为0.01至0.83)。因此,在这项基于人群的研究中,我们观察到较低的eGFR与较低的脑血流独立相关。

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