Study On Relation Of Cerebral Microbleeds And Its Distribution To Kidney Function In Patients With Ischemic Stroke/TIA

Subject With the development of neuroimaging technology,the detection rate of cerebral small vessel diseases is getting higher.CMBs is a subtype of cerebral small vessel diseases.It could increase the risk of hemorrhagic stroke and hemorrhagic transformation post infarcts.CMBs also plays an important role in cognition impairment.CMBs increases the rate of disability and reduces the quality of life in stroke patients.However,method of detecting CMBs is limited,excepted diagnosis based on imaging and pathological performance.As the vascular of brain and kidney have anatomic and vasoregulatory similarities,and they are allergic to ischemia.Our study was aimed to analyze the relation of cerebral microbleeds(CMBs)and its distribution to kidney function which is important to the prevention of CMBs and outcomes of ischemic stroke.Methods Our study originally retrospectively recruited patients with ischemic stroke /TIA from January 1,2014 to March 3,2016 in the department of neurology,the army general hospital.The data of demographic,history of disease,images and laboratory index of all patients were recorded,and the value of glomerular filtration rate was calculated by the formula of MDRD.the participants were classified into two groups depending on the presence of CMBs on the images.The differences of baseline data between the two groups were compared.The risk factors of CMBs were screened by univariate and multivariate logistic regression,and the relationship between CMBs and renal function was clarified.According to the location of CMBs will be divided into three categories.The correlations between location of CMBs and kidney function were determined by multinomial logistic regression analyses.Results 646 patients with ischemic stroke were included into our study.The incidence of CMBs was 25.7%(166 patients with CMBs).There were 373 male(57.7%),and the average age was 66.22±13.45.Compared to the baseline date of non-CMBs,elder age and white matter lesion were more frequent in the CMBs group(P=0.025,0.007).The level of creatinine,homocysteine,C-reactive protein and urea nitrogen were higher in patients with CMBs,while the glomerular filtration rate was lower(P<0.001).According to the standard of P<0.2 in univariate logistic regression analyses,age,sex,white matter lesion,hypertension,glycosylated hemoglobin,high-density lipoprotein,kidney dysfunction(GFR<90ml/min/1.73m2)and proteinuria were selected into multinomial logistic regression analyses.The result of analysis showed that kidney dysfunction and proteinuria were risk factors for CMBs,after adjusted by age,sex,hypertension and glycosylated hemoglobin(P=0.017,0.001.OR=1.624,3.702).the result of analyses for location of CMBs and kidney function showed that kidney dysfunction and proteinuria were risk factors for deep and mixed CMBs(P=0.001).Moreover,mixed CMBs presented in man patients more frequently(P=0.017).Conclusion Kidney dysfunction and proteinuria are risk factors for CMBs independent of age and hypertension.Moreover,they are risk factors for deep and mixed CMBs,but not for labor ones.The results suggest that excellent kidney function is important for the monitor and prevention of CMBs.Which will improve the long-term prognosis of ischemic stroke and decrease the process of cognitive decline.