The AGES-Reykjavik Study suggests that change in kidney measures is associated with subclinical brain pathology in older community-dwelling persons

Sanaz Sedaghat, Jie Ding, Gudny Eiriksdottir, Mark A. van Buchem, Sigurdur Sigurdsson, M. Arfan Ikram, Osorio Meirelles, Vilmundur Gudnason, Andrew S. Levey, Lenore J. Launer

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Decreased glomerular filtration rate (GFR) and albuminuria may be accompanied by brain pathology. Here we investigated whether changes in these kidney measures are linked to development of new MRI-detected infarcts and microbleeds, and progression of white matter hyperintensity volume. The study included 2671 participants from the population-based AGES-Reykjavik Study (mean age 75, 58.7% women). GFR was estimated from serum creatinine, and albuminuria was assessed by urinary albumin-to-creatinine ratio. Brain MRI was acquired at baseline (2002-2006) and 5 years later (2007-2011). New MRI-detected infarcts and microbleeds were counted on the follow-up scans. White matter hyperintensity progression was estimated as percent change in white matter hyperintensity volumes between the two exams. Participants with a large eGFR decline (over 3 ml/min/1.73m2 per year) had more incident subcortical infarcts (odds ratio 1.53; 95% confidence interval 1.05, 2.22), and more marked progression of white matter hyperintensity volume (difference: 8%; 95% confidence interval: 4%, 12%), compared to participants without a large decline. Participants with incident albuminuria (over 30 mg/g) had 21% more white matter hyperintensity volume progression (95% confidence interval: 14%, 29%) and 1.86 higher odds of developing new deep microbleeds (95% confidence interval 1.16, 2.98), compared to participants without incident albuminuria. The findings were independent of cardiovascular risk factors. Changes in kidney measures were not associated with occurrence of cortical infarcts. Thus, larger changes in eGFR and albuminuria are associated with increased risk for developing manifestations of cerebral small vessel disease. Individuals with larger changes in these kidney measures should be considered as a high risk population for accelerated brain pathology.

Original languageEnglish (US)
Pages (from-to)608-615
Number of pages8
JournalKidney international
Volume94
Issue number3
DOIs
StatePublished - Sep 2018
Externally publishedYes

Bibliographical note

Funding Information:
The AGES-Reykjavik Study was funded by contract N01-AG-12100 from the National Institutes of Health; by the Intramural Research Program of the National Institute on Aging; and by the Icelandic Heart Association and the Icelandic Parliament. SS is supported by a Rubicon fellowship of the Netherlands Organization for Scientific Research.

Publisher Copyright:
© 2018 International Society of Nephrology

Keywords

  • albuminuria
  • cortical infarcts
  • glomerular filtration rate
  • microbleeds
  • subcortical infarcts
  • white matter hyperintensity

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