Original InvestigationPathogenesis and Treatment of Kidney Disease and HypertensionSilent Cerebral White Matter Lesions and Their Relationship With Vascular Risk Factors in Middle-Aged Predialysis Patients With CKD
Section snippets
Study Population
We performed a cross-sectional study of 55 consecutive attending outpatients recruited from the Nephrology Service of the Joan XXIII University Hospital in Tarragona, Spain, and the Nephrology Assistance Unit, Hospital de Jesús, Tortosa, Tarragona. All patients were aged between 30 and 60 years and had CKD, with serum creatinine levels greater than 2.03 mg/dL (>179 μmol/L) and less than 7.91 mg/dL (<699 μmol/L). Exclusion criteria included: (1) diabetes mellitus and (2) clinical evidence of
Patient Characteristics
Three patients with CKD could not be scanned because they reported claustrophobia. Thus, imaging data were available for only 52 patients (38 men, 14 women). Mean age was 49 ± 9 years. The prevalence of white matter lesions was significantly greater in patients with CKD than controls (33% versus 6%; P = 0.008). Incidental findings observed in the MRI analysis of patients with CKD included a small extra-axial meningioma in 1 patient and a small cavernoma in another patient. No patient had a
Discussion
Our study supports the finding that middle-aged predialysis patients with CKD have significantly more silent cerebral white matter lesions than controls. In previous studies, white matter lesions were found in 27% to 87% of populations aged 65 years and older.1, 32 Our patients were selected on the basis of nondiabetic nephropathy as the cause of CKD to exclude the possible effect of diabetes as the predictor of white matter damage and age of 60 years or younger to exclude involutive brain
Acknowledgment
The authors thank Eugenia Masó and Magda Navarro for important cooperation and all the personnel of the magnetic resonance unit for their technical assistance throughout the study.
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Originally published online as doi:10.1053/j.ajkd.2005.10.029 on January 4, 2006.
Support: None. Potential conflicts of interest: None.