Chronic kidney disease is associated with white matter hyperintensity volume

The Northern Manhattan Study (NOMAS)

Minesh Khatri, Clinton B. Wright, Thomas L. Nickolas, Mitsuhiro Yoshita, Myunghee C. Paik, Grace Kranwinkel, Ralph L. Sacco, Charles DeCarli

Research output: Contribution to journalArticle

163 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE - White matter hyperintensities have been associated with increased risk of stroke, cognitive decline, and dementia. Chronic kidney disease is a risk factor for vascular disease and has been associated with inflammation and endothelial dysfunction, which have been implicated in the pathogenesis of white matter hyperintensities. Few studies have explored the relationship between chronic kidney disease and white matter hyperintensities. METHODS - The Northern Manhattan Study is a prospective, community-based cohort of which a subset of stroke-free participants underwent MRIs. MRIs were analyzed quantitatively for white matter hyperintensities volume, which was log-transformed to yield a normal distribution (log-white matter hyperintensity volume). Kidney function was modeled using serum creatinine, the Cockcroft-Gault formula for creatinine clearance, and the Modification of Diet in Renal Disease formula for estimated glomerular filtration rate. Creatinine clearance and estimated glomerular filtration rate were trichotomized to 15 to 60 mL/min, 60 to 90 mL/min, and >90 mL/min (reference). Linear regression was used to measure the association between kidney function and log-white matter hyperintensity volume adjusting for age, gender, race-ethnicity, education, cardiac disease, diabetes, homocysteine, and hypertension. RESULTS - Baseline data were available on 615 subjects (mean age 70 years, 60% women, 18% whites, 21% blacks, 62% Hispanics). In multivariate analysis, creatinine clearance 15 to 60 mL/min was associated with increased log-white matter hyperintensity volume (β 0.322; 95% CI, 0.095 to 0.550) as was estimated glomerular filtration rate 15 to 60 mL/min (β 0.322; 95% CI, 0.080 to 0.564). Serum creatinine, per 1-mg/dL increase, was also positively associated with log-white matter hyperintensity volume (β 1.479; 95% CI, 1.067 to 2.050). CONCLUSIONS - The association between moderate-severe chronic kidney disease and white matter hyperintensity volume highlights the growing importance of kidney disease as a possible determinant of cerebrovascular disease and/or as a marker of microangiopathy.

Original languageEnglish (US)
Pages (from-to)3121-3126
Number of pages6
JournalStroke
Volume38
Issue number12
DOIs
StatePublished - Dec 2007

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Chronic Renal Insufficiency
Creatinine
Glomerular Filtration Rate
Kidney
Stroke
Diet Therapy
White Matter
Cerebrovascular Disorders
Normal Distribution
Kidney Diseases
Homocysteine
Serum
Vascular Diseases
Hispanic Americans
Dementia
Linear Models
Heart Diseases
Multivariate Analysis
Hypertension
Inflammation

Keywords

  • Chronic
  • Kidney failure
  • Leukoaraiosis
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Chronic kidney disease is associated with white matter hyperintensity volume : The Northern Manhattan Study (NOMAS). / Khatri, Minesh; Wright, Clinton B.; Nickolas, Thomas L.; Yoshita, Mitsuhiro; Paik, Myunghee C.; Kranwinkel, Grace; Sacco, Ralph L.; DeCarli, Charles.

In: Stroke, Vol. 38, No. 12, 12.2007, p. 3121-3126.

Research output: Contribution to journalArticle

Khatri, M, Wright, CB, Nickolas, TL, Yoshita, M, Paik, MC, Kranwinkel, G, Sacco, RL & DeCarli, C 2007, 'Chronic kidney disease is associated with white matter hyperintensity volume: The Northern Manhattan Study (NOMAS)', Stroke, vol. 38, no. 12, pp. 3121-3126. https://doi.org/10.1161/STROKEAHA.107.493593
Khatri, Minesh ; Wright, Clinton B. ; Nickolas, Thomas L. ; Yoshita, Mitsuhiro ; Paik, Myunghee C. ; Kranwinkel, Grace ; Sacco, Ralph L. ; DeCarli, Charles. / Chronic kidney disease is associated with white matter hyperintensity volume : The Northern Manhattan Study (NOMAS). In: Stroke. 2007 ; Vol. 38, No. 12. pp. 3121-3126.
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abstract = "BACKGROUND AND PURPOSE - White matter hyperintensities have been associated with increased risk of stroke, cognitive decline, and dementia. Chronic kidney disease is a risk factor for vascular disease and has been associated with inflammation and endothelial dysfunction, which have been implicated in the pathogenesis of white matter hyperintensities. Few studies have explored the relationship between chronic kidney disease and white matter hyperintensities. METHODS - The Northern Manhattan Study is a prospective, community-based cohort of which a subset of stroke-free participants underwent MRIs. MRIs were analyzed quantitatively for white matter hyperintensities volume, which was log-transformed to yield a normal distribution (log-white matter hyperintensity volume). Kidney function was modeled using serum creatinine, the Cockcroft-Gault formula for creatinine clearance, and the Modification of Diet in Renal Disease formula for estimated glomerular filtration rate. Creatinine clearance and estimated glomerular filtration rate were trichotomized to 15 to 60 mL/min, 60 to 90 mL/min, and >90 mL/min (reference). Linear regression was used to measure the association between kidney function and log-white matter hyperintensity volume adjusting for age, gender, race-ethnicity, education, cardiac disease, diabetes, homocysteine, and hypertension. RESULTS - Baseline data were available on 615 subjects (mean age 70 years, 60{\%} women, 18{\%} whites, 21{\%} blacks, 62{\%} Hispanics). In multivariate analysis, creatinine clearance 15 to 60 mL/min was associated with increased log-white matter hyperintensity volume (β 0.322; 95{\%} CI, 0.095 to 0.550) as was estimated glomerular filtration rate 15 to 60 mL/min (β 0.322; 95{\%} CI, 0.080 to 0.564). Serum creatinine, per 1-mg/dL increase, was also positively associated with log-white matter hyperintensity volume (β 1.479; 95{\%} CI, 1.067 to 2.050). CONCLUSIONS - The association between moderate-severe chronic kidney disease and white matter hyperintensity volume highlights the growing importance of kidney disease as a possible determinant of cerebrovascular disease and/or as a marker of microangiopathy.",
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author = "Minesh Khatri and Wright, {Clinton B.} and Nickolas, {Thomas L.} and Mitsuhiro Yoshita and Paik, {Myunghee C.} and Grace Kranwinkel and Sacco, {Ralph L.} and Charles DeCarli",
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T1 - Chronic kidney disease is associated with white matter hyperintensity volume

T2 - The Northern Manhattan Study (NOMAS)

AU - Khatri, Minesh

AU - Wright, Clinton B.

AU - Nickolas, Thomas L.

AU - Yoshita, Mitsuhiro

AU - Paik, Myunghee C.

AU - Kranwinkel, Grace

AU - Sacco, Ralph L.

AU - DeCarli, Charles

PY - 2007/12

Y1 - 2007/12

N2 - BACKGROUND AND PURPOSE - White matter hyperintensities have been associated with increased risk of stroke, cognitive decline, and dementia. Chronic kidney disease is a risk factor for vascular disease and has been associated with inflammation and endothelial dysfunction, which have been implicated in the pathogenesis of white matter hyperintensities. Few studies have explored the relationship between chronic kidney disease and white matter hyperintensities. METHODS - The Northern Manhattan Study is a prospective, community-based cohort of which a subset of stroke-free participants underwent MRIs. MRIs were analyzed quantitatively for white matter hyperintensities volume, which was log-transformed to yield a normal distribution (log-white matter hyperintensity volume). Kidney function was modeled using serum creatinine, the Cockcroft-Gault formula for creatinine clearance, and the Modification of Diet in Renal Disease formula for estimated glomerular filtration rate. Creatinine clearance and estimated glomerular filtration rate were trichotomized to 15 to 60 mL/min, 60 to 90 mL/min, and >90 mL/min (reference). Linear regression was used to measure the association between kidney function and log-white matter hyperintensity volume adjusting for age, gender, race-ethnicity, education, cardiac disease, diabetes, homocysteine, and hypertension. RESULTS - Baseline data were available on 615 subjects (mean age 70 years, 60% women, 18% whites, 21% blacks, 62% Hispanics). In multivariate analysis, creatinine clearance 15 to 60 mL/min was associated with increased log-white matter hyperintensity volume (β 0.322; 95% CI, 0.095 to 0.550) as was estimated glomerular filtration rate 15 to 60 mL/min (β 0.322; 95% CI, 0.080 to 0.564). Serum creatinine, per 1-mg/dL increase, was also positively associated with log-white matter hyperintensity volume (β 1.479; 95% CI, 1.067 to 2.050). CONCLUSIONS - The association between moderate-severe chronic kidney disease and white matter hyperintensity volume highlights the growing importance of kidney disease as a possible determinant of cerebrovascular disease and/or as a marker of microangiopathy.

AB - BACKGROUND AND PURPOSE - White matter hyperintensities have been associated with increased risk of stroke, cognitive decline, and dementia. Chronic kidney disease is a risk factor for vascular disease and has been associated with inflammation and endothelial dysfunction, which have been implicated in the pathogenesis of white matter hyperintensities. Few studies have explored the relationship between chronic kidney disease and white matter hyperintensities. METHODS - The Northern Manhattan Study is a prospective, community-based cohort of which a subset of stroke-free participants underwent MRIs. MRIs were analyzed quantitatively for white matter hyperintensities volume, which was log-transformed to yield a normal distribution (log-white matter hyperintensity volume). Kidney function was modeled using serum creatinine, the Cockcroft-Gault formula for creatinine clearance, and the Modification of Diet in Renal Disease formula for estimated glomerular filtration rate. Creatinine clearance and estimated glomerular filtration rate were trichotomized to 15 to 60 mL/min, 60 to 90 mL/min, and >90 mL/min (reference). Linear regression was used to measure the association between kidney function and log-white matter hyperintensity volume adjusting for age, gender, race-ethnicity, education, cardiac disease, diabetes, homocysteine, and hypertension. RESULTS - Baseline data were available on 615 subjects (mean age 70 years, 60% women, 18% whites, 21% blacks, 62% Hispanics). In multivariate analysis, creatinine clearance 15 to 60 mL/min was associated with increased log-white matter hyperintensity volume (β 0.322; 95% CI, 0.095 to 0.550) as was estimated glomerular filtration rate 15 to 60 mL/min (β 0.322; 95% CI, 0.080 to 0.564). Serum creatinine, per 1-mg/dL increase, was also positively associated with log-white matter hyperintensity volume (β 1.479; 95% CI, 1.067 to 2.050). CONCLUSIONS - The association between moderate-severe chronic kidney disease and white matter hyperintensity volume highlights the growing importance of kidney disease as a possible determinant of cerebrovascular disease and/or as a marker of microangiopathy.

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KW - Kidney failure

KW - Leukoaraiosis

KW - Magnetic resonance imaging

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