Abstract: TH-OR004

Increased Risk of Premature Cerebral Small Vessel Diseases in Dialysis Patients: A Cross-Sectional Controlled Study

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Zheng, Ke, Peking Union Medical College Hospital, Beijing, China
  • Wang, Haiyun, Peking Union Medical College Hospital, Beijing, China
Background

Growing evidence suggests a higher prevalence of cerebrovascular diseases in patients with end-stage renal disease and undergoing dialysis. As an important cause of stroke, dementia or disability, cerebral small vessel disease (CSVD) has been recognized recently. However, discovery of CVSD needs brain resonance imaging (MRI) scan. There were only small sample size non-controlled study in this field. These limited us to get a further understanding of CSVD in dialysis population. By now, a comprehensive controlled assessment of CSVD in a dialysis cohort of large sample size is lacking.

Methods

In this cross-sectional controlled study, we enrolled a total of 179 dialysis patients (116 in hemodialysis (HD) and 63 in peritoneal dialysis (PD)) and 351 matched non-chronic kidney disease (CKD) controls. We collected detailed clinical characteristics and all participants underwent brain MRI. We assessed and compared the presence and location of CSVD in the dialysis patients and controls, including lacunes, microbleeds, and white matter hyperintensities (WMH). We used univariable and multivariable logistic regression to investigate the risk factors.

Results

Prevalence of the CSVD lesions were significantly higher in the dialysis patients compared with non-CKD controls (OR: 1.86 (95% CI 1.23–2.81) in lacunes; 3.61 (95% CI2.32–5.61) in microbleeds; 1.92 (95% CI 1.31–2.82) in WMH). In dialysis patients, the majority of lacunes were detected in the subcortical white matter and basal ganglia, while the majority of the microbleeds were found in the lobes and basal ganglia. After adjusting age, dialysis vintage, hypertension, diabetes mellitus (DM), hyperlipidemia, smoking and drinking habits, significantly increased risk was observed in the dialysis patients for microbleeds (OR 2.82, 95% CI1.70-4.65) and WMH with total Fazekas larger than two (OR 2.04,95% CI1.25-3.34). Finally, the age of lesion detection was significantly smaller in dialysis patients ((p=0.017, 0.004 and 0.020 for lacunes, microbleeds and WMH). In our dialysis cohort, these was no significant differences in all three types of CSVD lesions between HD and PD modality.

Conclusion

Patients on dialysis were associated with significantly increased risk of CSVD comparing with controls, they also demonstrated a tendency premature CSVD.

Funding

  • Government Support - Non-U.S.