Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: The Ohasama study

Harunori Otani, Masahiro Kikuya, Azusa Hara, Shiho Terata, Takayoshi Ohkubo, Takeo Kondo, Takuo Hirose, Taku Obara, Hirohito Metoki, Ryusuke Inoue, Kei Asayama, Atsuhiro Kanno, Hiroyuki Terawaki, Masaaki Nakayama, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Shin Ichi Izumi, Yutaka Imai

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: No previous study has investigated the association of kidney dysfunction with silent lacunar infarcts and white-matter hyperintensity (WMH) independent of ambulatory blood pressure (BP). Methods: A cross-sectional study involving 1,008 participants (mean age 66 years) from a general population of Ohasama, Japan, was conducted. Calculated creatinine clearance (CCr) was estimated using the Cockcroft-Gault equation. In continuous and categorical analyses, the association between CCr and the prevalence of silent lacunar infarcts and WMH was investigated. Silent lacunar infarcts and WMH were detected on MRI. Multiple logistic regression analysis adjusted for 24-hour ambulatory BP, sex, age, body mass index, smoking and drinking status, antihypertensive medication, and histories of hypercholesterolemia, diabetes mellitus and heart disease was performed. Results: On univariate analysis, decreased CCr (continuous variable) and CCr <60 ml/min/1.73 m2 (categorical variable) were significantly associated with lacunar infarcts and WMH. After adjustment, each 1-standard-deviation decrease in CCr (odds ratio = 1.22; p = 0.036) and CCr <60 ml/min/1.73 m2 (odds ratio = 1.68; p = 0.007) was significantly associated with a high prevalence of lacunar infarcts. Even when 24-hour ambulatory BP was within the normal range (<130/80 mm Hg), CCr <60 ml/min/1.73 m2 was associated with a high prevalence of lacunar infarcts (odds ratio = 1.62; p = 0.047). CCr <60 ml/min/1.73 m 2 and 24-hour ambulatory BP had additive effects on lacunar infarcts. After the same adjustment, the association between CCr and WMH was not significant. Conclusions: CCr is closely associated with lacunar infarcts, suggesting that kidney dysfunction in the elderly is an independent risk factor or predictor for silent lacunar infarcts.

Original languageEnglish
Pages (from-to)43-50
Number of pages8
JournalCerebrovascular Diseases
Volume30
Issue number1
DOIs
Publication statusPublished - 2010 Jun 1
Externally publishedYes

Fingerprint

Lacunar Stroke
Creatinine
Kidney
Population
Blood Pressure
Social Adjustment
Odds Ratio
White Matter
Hypercholesterolemia
Antihypertensive Agents
Drinking
Heart Diseases
Diabetes Mellitus
Japan
Reference Values
Body Mass Index
Cross-Sectional Studies
Logistic Models
Smoking
Regression Analysis

Keywords

  • Ambulatory blood pressure
  • Chronic kidney disease
  • General population
  • Lacunar infarcts
  • White-matter hyperintensity

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population : The Ohasama study. / Otani, Harunori; Kikuya, Masahiro; Hara, Azusa; Terata, Shiho; Ohkubo, Takayoshi; Kondo, Takeo; Hirose, Takuo; Obara, Taku; Metoki, Hirohito; Inoue, Ryusuke; Asayama, Kei; Kanno, Atsuhiro; Terawaki, Hiroyuki; Nakayama, Masaaki; Totsune, Kazuhito; Hoshi, Haruhisa; Satoh, Hiroshi; Izumi, Shin Ichi; Imai, Yutaka.

In: Cerebrovascular Diseases, Vol. 30, No. 1, 01.06.2010, p. 43-50.

Research output: Contribution to journalArticle

Otani, H, Kikuya, M, Hara, A, Terata, S, Ohkubo, T, Kondo, T, Hirose, T, Obara, T, Metoki, H, Inoue, R, Asayama, K, Kanno, A, Terawaki, H, Nakayama, M, Totsune, K, Hoshi, H, Satoh, H, Izumi, SI & Imai, Y 2010, 'Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: The Ohasama study', Cerebrovascular Diseases, vol. 30, no. 1, pp. 43-50. https://doi.org/10.1159/000313612
Otani, Harunori ; Kikuya, Masahiro ; Hara, Azusa ; Terata, Shiho ; Ohkubo, Takayoshi ; Kondo, Takeo ; Hirose, Takuo ; Obara, Taku ; Metoki, Hirohito ; Inoue, Ryusuke ; Asayama, Kei ; Kanno, Atsuhiro ; Terawaki, Hiroyuki ; Nakayama, Masaaki ; Totsune, Kazuhito ; Hoshi, Haruhisa ; Satoh, Hiroshi ; Izumi, Shin Ichi ; Imai, Yutaka. / Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population : The Ohasama study. In: Cerebrovascular Diseases. 2010 ; Vol. 30, No. 1. pp. 43-50.
@article{a256f2de5547462ca6a3f159f650ee3d,
title = "Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population: The Ohasama study",
abstract = "Background: No previous study has investigated the association of kidney dysfunction with silent lacunar infarcts and white-matter hyperintensity (WMH) independent of ambulatory blood pressure (BP). Methods: A cross-sectional study involving 1,008 participants (mean age 66 years) from a general population of Ohasama, Japan, was conducted. Calculated creatinine clearance (CCr) was estimated using the Cockcroft-Gault equation. In continuous and categorical analyses, the association between CCr and the prevalence of silent lacunar infarcts and WMH was investigated. Silent lacunar infarcts and WMH were detected on MRI. Multiple logistic regression analysis adjusted for 24-hour ambulatory BP, sex, age, body mass index, smoking and drinking status, antihypertensive medication, and histories of hypercholesterolemia, diabetes mellitus and heart disease was performed. Results: On univariate analysis, decreased CCr (continuous variable) and CCr <60 ml/min/1.73 m2 (categorical variable) were significantly associated with lacunar infarcts and WMH. After adjustment, each 1-standard-deviation decrease in CCr (odds ratio = 1.22; p = 0.036) and CCr <60 ml/min/1.73 m2 (odds ratio = 1.68; p = 0.007) was significantly associated with a high prevalence of lacunar infarcts. Even when 24-hour ambulatory BP was within the normal range (<130/80 mm Hg), CCr <60 ml/min/1.73 m2 was associated with a high prevalence of lacunar infarcts (odds ratio = 1.62; p = 0.047). CCr <60 ml/min/1.73 m 2 and 24-hour ambulatory BP had additive effects on lacunar infarcts. After the same adjustment, the association between CCr and WMH was not significant. Conclusions: CCr is closely associated with lacunar infarcts, suggesting that kidney dysfunction in the elderly is an independent risk factor or predictor for silent lacunar infarcts.",
keywords = "Ambulatory blood pressure, Chronic kidney disease, General population, Lacunar infarcts, White-matter hyperintensity",
author = "Harunori Otani and Masahiro Kikuya and Azusa Hara and Shiho Terata and Takayoshi Ohkubo and Takeo Kondo and Takuo Hirose and Taku Obara and Hirohito Metoki and Ryusuke Inoue and Kei Asayama and Atsuhiro Kanno and Hiroyuki Terawaki and Masaaki Nakayama and Kazuhito Totsune and Haruhisa Hoshi and Hiroshi Satoh and Izumi, {Shin Ichi} and Yutaka Imai",
year = "2010",
month = "6",
day = "1",
doi = "10.1159/000313612",
language = "English",
volume = "30",
pages = "43--50",
journal = "Cerebrovascular Diseases",
issn = "1015-9770",
publisher = "S. Karger AG",
number = "1",

}

TY - JOUR

T1 - Association of kidney dysfunction with silent lacunar infarcts and white matter hyperintensity in the general population

T2 - The Ohasama study

AU - Otani, Harunori

AU - Kikuya, Masahiro

AU - Hara, Azusa

AU - Terata, Shiho

AU - Ohkubo, Takayoshi

AU - Kondo, Takeo

AU - Hirose, Takuo

AU - Obara, Taku

AU - Metoki, Hirohito

AU - Inoue, Ryusuke

AU - Asayama, Kei

AU - Kanno, Atsuhiro

AU - Terawaki, Hiroyuki

AU - Nakayama, Masaaki

AU - Totsune, Kazuhito

AU - Hoshi, Haruhisa

AU - Satoh, Hiroshi

AU - Izumi, Shin Ichi

AU - Imai, Yutaka

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Background: No previous study has investigated the association of kidney dysfunction with silent lacunar infarcts and white-matter hyperintensity (WMH) independent of ambulatory blood pressure (BP). Methods: A cross-sectional study involving 1,008 participants (mean age 66 years) from a general population of Ohasama, Japan, was conducted. Calculated creatinine clearance (CCr) was estimated using the Cockcroft-Gault equation. In continuous and categorical analyses, the association between CCr and the prevalence of silent lacunar infarcts and WMH was investigated. Silent lacunar infarcts and WMH were detected on MRI. Multiple logistic regression analysis adjusted for 24-hour ambulatory BP, sex, age, body mass index, smoking and drinking status, antihypertensive medication, and histories of hypercholesterolemia, diabetes mellitus and heart disease was performed. Results: On univariate analysis, decreased CCr (continuous variable) and CCr <60 ml/min/1.73 m2 (categorical variable) were significantly associated with lacunar infarcts and WMH. After adjustment, each 1-standard-deviation decrease in CCr (odds ratio = 1.22; p = 0.036) and CCr <60 ml/min/1.73 m2 (odds ratio = 1.68; p = 0.007) was significantly associated with a high prevalence of lacunar infarcts. Even when 24-hour ambulatory BP was within the normal range (<130/80 mm Hg), CCr <60 ml/min/1.73 m2 was associated with a high prevalence of lacunar infarcts (odds ratio = 1.62; p = 0.047). CCr <60 ml/min/1.73 m 2 and 24-hour ambulatory BP had additive effects on lacunar infarcts. After the same adjustment, the association between CCr and WMH was not significant. Conclusions: CCr is closely associated with lacunar infarcts, suggesting that kidney dysfunction in the elderly is an independent risk factor or predictor for silent lacunar infarcts.

AB - Background: No previous study has investigated the association of kidney dysfunction with silent lacunar infarcts and white-matter hyperintensity (WMH) independent of ambulatory blood pressure (BP). Methods: A cross-sectional study involving 1,008 participants (mean age 66 years) from a general population of Ohasama, Japan, was conducted. Calculated creatinine clearance (CCr) was estimated using the Cockcroft-Gault equation. In continuous and categorical analyses, the association between CCr and the prevalence of silent lacunar infarcts and WMH was investigated. Silent lacunar infarcts and WMH were detected on MRI. Multiple logistic regression analysis adjusted for 24-hour ambulatory BP, sex, age, body mass index, smoking and drinking status, antihypertensive medication, and histories of hypercholesterolemia, diabetes mellitus and heart disease was performed. Results: On univariate analysis, decreased CCr (continuous variable) and CCr <60 ml/min/1.73 m2 (categorical variable) were significantly associated with lacunar infarcts and WMH. After adjustment, each 1-standard-deviation decrease in CCr (odds ratio = 1.22; p = 0.036) and CCr <60 ml/min/1.73 m2 (odds ratio = 1.68; p = 0.007) was significantly associated with a high prevalence of lacunar infarcts. Even when 24-hour ambulatory BP was within the normal range (<130/80 mm Hg), CCr <60 ml/min/1.73 m2 was associated with a high prevalence of lacunar infarcts (odds ratio = 1.62; p = 0.047). CCr <60 ml/min/1.73 m 2 and 24-hour ambulatory BP had additive effects on lacunar infarcts. After the same adjustment, the association between CCr and WMH was not significant. Conclusions: CCr is closely associated with lacunar infarcts, suggesting that kidney dysfunction in the elderly is an independent risk factor or predictor for silent lacunar infarcts.

KW - Ambulatory blood pressure

KW - Chronic kidney disease

KW - General population

KW - Lacunar infarcts

KW - White-matter hyperintensity

UR - http://www.scopus.com/inward/record.url?scp=77951539173&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951539173&partnerID=8YFLogxK

U2 - 10.1159/000313612

DO - 10.1159/000313612

M3 - Article

C2 - 20431289

AN - SCOPUS:77951539173

VL - 30

SP - 43

EP - 50

JO - Cerebrovascular Diseases

JF - Cerebrovascular Diseases

SN - 1015-9770

IS - 1

ER -