The following is a summary of “Chronic kidney disease and its association with cerebral small vessel disease in the general older hypertensive population,” published in the March 2024 issue of Nephrology by Månsson et al.

Magnetic resonance imaging identifies cerebral small vessel disease, which encompasses white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Shared risk factors, notably hypertension, link it with chronic kidney disease (CKD).

Researchers conducted a retrospective study to investigate the connection between CKD and cerebral small vessel disease and to examine the influence of hypertension on this association.

They employed a cross-sectional study design, drawing data from 390 older adults participating in the Good Aging in Skåne study. CKD was characterized by a glomerular filtration rate below 60 ml/min/1.73m². Utilizing logistic regression models adjusted for age and sex, they investigated the links between CKD and magnetic resonance imaging indicators of cerebral small vessel disease. A secondary analysis was conducted, wherein the study sample was stratified based on hypertension status, and similar calculations were performed.

The results showed that, after adjusting for age and sex across the entire cohort, CKD was not linked with any cerebral small vessel disease markers. Upon further analysis with stratification by hypertension status and adjustment for age and sex, it was found that CKD exhibited an association with cerebral microbleeds (OR 1.93, CI 1.04–3.59, p-value 0.037) and cortical atrophy (OR 2.45, CI 1.34–4.48, p-value 0.004) solely within the hypertensive subgroup. No significant associations were observed within the non-hypertensive subgroup.

Investigators concluded that CKD in an older population with hypertension may be linked to increased cerebral small vessel disease, suggesting hypertension as a potential bridge between the two conditions.

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03528-8