Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University.
Department of Vascular Ultrasound, Xuanwu Hospital, Capital Medical University.
J Atheroscler Thromb. 2020 Mar 1;27(3):245-254. doi: 10.5551/jat.49569. Epub 2019 Aug 28.
To investigate the association of chronic kidney disease (CKD) and intracranial artery stenosis (ICAS), as well as its effects on ICAS distribution in the middle-aged and elderly population.
Data from the China Hypertension Survey in Beijing was analyzed. Estimated glomerular filtration rate (eGFR) was used to evaluate CKD, and ICAS was assessed by transcranial doppler. Clinical and biochemical variables were compared between the ICAS group and the non-ICAS group, as well as in different vascular distribution groups. Univariable and multivariable logistic regression analyses were introduced to demonstrate the association between CKD and ICAS.
A total of 3678 subjects were included in this study, with a mean age of 62 years old. Of which, 19.2% presented with decreased eGFR (eGFR <60 ml/min/1.73 m) and 17.4% for ICAS. The percentage of anterior circulation ICAS was 3.5 times than that of posterior circulation (10.9% vs. 3.1%). In multivariable regression analysis, eGFR <45 ml/min/1.73 m was independently associated with ICAS after correction for covariates, odds ratio (OR)=1.69, 95% confidence interval (CI) (1.08, 2.65); in particular, this association had a preference for posterior circulation but not anterior circulation ICAS with OR=2.29, 95% CI (1.28, 4.07) and OR=1.44, 95%CI (0.89, 2.33), respectively.
Severe eGFR decline is associated with ICAS in the middle-aged and elderly population, and this correlation is more related to posterior circulation ICAS.
探讨慢性肾脏病(CKD)与颅内动脉狭窄(ICAS)的关系及其对中老年人 ICAS 分布的影响。
分析北京中国高血压调查的数据。采用估算肾小球滤过率(eGFR)评估 CKD,经颅多普勒评估 ICAS。比较 ICAS 组与非 ICAS 组以及不同血管分布组的临床和生化变量。采用单变量和多变量逻辑回归分析显示 CKD 与 ICAS 之间的关系。
本研究共纳入 3678 例受试者,平均年龄 62 岁。其中,19.2%的患者 eGFR 降低(eGFR<60ml/min/1.73m),17.4%的患者存在 ICAS。前循环 ICAS 的比例是后循环的 3.5 倍(10.9%比 3.1%)。多变量回归分析显示,校正混杂因素后,eGFR<45ml/min/1.73m 与 ICAS 独立相关,比值比(OR)为 1.69,95%置信区间(CI)为(1.08,2.65);特别是这种关联更倾向于后循环而不是前循环 ICAS,OR 值分别为 2.29(95%CI:1.28,4.07)和 1.44(95%CI:0.89,2.33)。
中老年人严重的 eGFR 下降与 ICAS 相关,这种相关性与后循环 ICAS 更相关。