Relationship between chronic kidney disease and silent cerebral infarction in patients with Type2 diabetes

Diabet. Med. 27, 538-543 (2010) Aims Silent cerebral infarction (SCI) is an independent risk factor for future symptomatic stroke. Although the prevalence of SCI is closely related to kidney function in non-diabetic individuals, evidence is lacking whether albuminuria and/or reduced estimated glomer...

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Published in:Diabetic medicine 2010-05, Vol.27 (5), p.538-543
Main Authors: Bouchi, R, Babazono, T, Yoshida, N, Nyumura, I, Toya, K, Hayashi, T, Hanai, K, Tanaka, N, Ishii, A, Iwamoto, Y
Format: Article
Language:English
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Summary:Diabet. Med. 27, 538-543 (2010) Aims Silent cerebral infarction (SCI) is an independent risk factor for future symptomatic stroke. Although the prevalence of SCI is closely related to kidney function in non-diabetic individuals, evidence is lacking whether albuminuria and/or reduced estimated glomerular filtration rate (eGFR) independently increase the risk of SCI in diabetic patients. We therefore examined the relationships between albuminuria, eGFR and SCI in patients with Type2 diabetes mellitus (T2DM). Methods We studied 786 T2DM patients with an eGFR greater than or equal to 15ml/min 1.73/m super(2), including 337 women and 449 men [mean ( plus or minus sd), age 65 plus or minus 11years]. All patients underwent cranial magnetic resonance imaging (MRI) to detect SCI. GFR was estimated using the modified three-variable equation for Japanese subjects. Albuminuria was defined as a first morning urinary albumin-to-creatinine ratio (ACR) greater than or equal to 30mg/g. Results SCI was detected in 415 (52.8%) of the subjects. The prevalence of SCI was significantly associated with both elevated ACR and decreased eGFR in univariate analysis. In multivariate logistic regression analysis, urinary ACR remained independently associated with SCI after adjusting for conventional cardiovascular risk factors [odds ratio (OR) of urinary ACR per logarithmical value: 1.89, 95% confidence interval (CI)=1.41-2.51, P
ISSN:0742-3071
1464-5491
DOI:10.1111/j.1464-5491.2010.02922.x