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慢性肾脏病与脑小血管病的 MRI 表现相关。

Chronic kidney disease correlates with MRI findings of cerebral small vessel disease.

机构信息

Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Ren Fail. 2021 Dec;43(1):255-263. doi: 10.1080/0886022X.2021.1873804.

Abstract

Cerebral small vessel disease (CSVD) and chronic kidney disease (CKD) may be part of a multisystem small-vessel disorder. Since the kidney and brain share unique susceptibilities to vascular injury, kidney impairment may be predictive of the presence and severity of CSVD. This study explored the relationship between CSVD and CKD. Between December 2015 and December 2017 (follow-up 10-20 months) 52 patients with chronic nephritis and CKD were classified into a progressive group ( = 17) and stable group ( = 35). Age, gender, hypertension, diabetes and smoking were matched between groups. CSVD features of both groups, including enlarged Virchow-Robin spaces (VRS), white matter lesions (WML), lacunar infarcts (LI), and cerebral microbleeds (CMB) were evaluated by magnetic resonance (MR) imaging. WML and CMB in the progressive group were exacerbated at follow-up compared to initial exam ( = 0.004 and 0.041, respectively). There was no significant change in VRS, WML, LI, or CMB in the stable group at follow-up compared to initial exam. CMB were significantly different between the progressive group and stable group at follow-up.etimtaed Glomerular filtration rate (eGFR) was significantly correlated with VRS, WML, and CMB at follow-up ( = 0.037, 0.041, and 0.009, respectively). Patients with progressive CKD have a higher prevalence and severity of CSVD, which correlates with deterioration of renal function as assessed by decreased eGFR. Thus EGFR may also be of value in the prediction of cerebral small vessel disease.

摘要

脑小血管病(CSVD)和慢性肾脏病(CKD)可能是多系统小血管疾病的一部分。由于肾脏和大脑对血管损伤具有独特的易感性,因此肾脏损害可能预示着 CSVD 的存在和严重程度。本研究探讨了 CSVD 与 CKD 之间的关系。

在 2015 年 12 月至 2017 年 12 月期间(随访 10-20 个月),将 52 例慢性肾炎和 CKD 患者分为进展组( = 17)和稳定组( = 35)。两组间年龄、性别、高血压、糖尿病和吸烟情况相匹配。采用磁共振成像(MR)评估两组的 CSVD 特征,包括扩大的 Virchow-Robin 空间(VRS)、白质病变(WML)、腔隙性梗死(LI)和脑微出血(CMB)。

与初次检查相比,进展组在随访时 WML 和 CMB 加重(分别为 = 0.004 和 0.041)。稳定组在随访时 VRS、WML、LI 或 CMB 与初次检查相比无明显变化。与稳定组相比,进展组在随访时 CMB 差异有统计学意义。估算肾小球滤过率(eGFR)与随访时的 VRS、WML 和 CMB 呈显著相关(分别为 = 0.037、0.041 和 0.009)。

进展性 CKD 患者 CSVD 的患病率和严重程度更高,这与肾功能恶化(通过降低 eGFR 评估)相关。因此,eGFR 可能对脑小血管疾病的预测也具有价值。

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