Kidney Function and White Matter Disease in Young Stroke Patients Analysis of the Stroke in Young Fabry Patients Study Population

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Abstract

Background and Purpose-Impaired kidney function is thought to be associated with small vessel disease, outcome, and mortality in the general stroke population. Data are limited regarding young patients. The aim of this study was to investigate the association of kidney function and white matter hyperintensities (WMHs) in young patients with first ischemic stroke. Methods-We analyzed 2500 young (18-55 years) patients with first-ever ischemic stroke from the prospective observational Stroke in Young Fabry Patients (SIFAP1) study with available MRI data on WMH. Of these, 2009 had available data concerning estimated glomerular filtration rate (eGFR). Kidney function was expressed as eGFR by the Modification of Diet in Renal Disease method. Deep WMHs on MRI were classified by the Fazekas score. Multivariate analysis was performed using a regression model with random effects. Results-Mean eGFR was 96.7 mL/min in those with WMH Grade 0 to 1 (none to mild), 90.7 mL/min in WMH Grade 2 (moderate), and 89 mL/min in WMH Grade 3 (severe). Univariate analysis revealed WMH to be associated with age (P<0.001), hypertension (P<0.001), cardiovascular disease (P=0.015), overweight (body mass index >25 kg/m(2); P=0.013), current smoking (P=0.044), and eGFR (P=0.009). In multivariate analysis, age, hypertension, and eGFR remained associated with WMH severity. Conclusions-In young patients with acute ischemic stroke, lower eGFR values in the normal range are associated with the presence of moderate to severe WMH.

Details

Authors
  • Robert Steinicke
  • Beate Gaertner
  • Ulrike Grittner
  • Wolf Schmidt
  • Martin Dichgans
  • Peter U. Heuschmann
  • Christian Tanislav
  • Jukka Putaala
  • Manfred Kaps
  • Matthias Endres
  • Reinhold Schmidt
  • Franz Fazekas
  • Bo Norrving
  • Arndt Rolfs
  • Peter Martus
  • Turgut Tatlisumak
  • Christian Enzinger
  • Gerhard Jan Jungehulsing
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Neurology

Keywords

  • estimated glomerular filtration rate (eGFR) kidney function, MRI, stroke, white matter hyperintensities (WMH)
Original languageEnglish
Pages (from-to)2382-2388
Journal Stroke: a journal of cerebral circulation
Volume43
Issue number9
Publication statusPublished - 2012
Publication categoryResearch
Peer-reviewedYes