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Abstract: TH-PO455

Association of Vascular Calcification with Brain Atrophy in Patients with CKD: Cross-Sectional and Longitudinal Analyses

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Japan
  • Yoshida, Hisako, Osaka City University Graduate School of Medicine, Osaka, Japan
  • Nakano, Toshiaki, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Kitazono, Takanari, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Background

It has been reported that brain atrophy (BA) progresses rapidly in chronic kidney disease (CKD) patients, especially in patients on hemodialysis (HD). We previously demonstrated that BA progressed more rapidly in patients on peritoneal dialysis (PD) compared with patients with non-dialysis dependent CKD (ND) (Tsuruya K, et al. AJKD, 2015). Vascular calcification (VC) has been considered to be an independent risk factor for cardiovascular disease including cerebrovascular disease; however, it remains unclear whether VC affects BA. Thus, we examined the association between VC and BA by cross-sectional and longitudinal analyses among CKD patients.

Methods

In the present study, 157 CKD (90 ND, 42 PD, and 25 HD) patients aged 62 (mean) ± 10 (SD) years (men 91, diabetes 46) were recruited and underwent MRI scanning at baseline and after two years. T1-weighted MRI images were analyzed with statistical parametric mapping software. Total gray matter (GM), total white matter (WM), and cerebrospinal fluid (CSF) were segmented and each volume was quantified using MRI voxel-based morphometry. GM ratio (GMR), calculated by normalization of GM volume to intracranial volume determined by summation of GM, WM, and CSF volume, and annual reduction rate of GMR (ARR-GMR) were used to evaluate BA. At baseline, all participants underwent multidetector computed tomography to assess coronary artery calcification score (CACS) and the values were transformed into the square root values (SR-CACS) to reduce the skewed distribution. We examined the associations of SR-CACS with GMR and ARR-GMR using multiple regression analysis.

Results

The mean GMR significantly decreased from 40.0% at baseline to 39.2% after 2 years, and the mean ARR-GMR was 0.38 percentage-point. SR-CACS was significantly negatively associated with GMR and positively associated with ARR-GMR. The association with GMR remained significant even after adjustment for age, sex, diabetes, systolic blood pressure, hemoglobin, dialysis status (ND, PD, or HD), current smoking, and regular drinking (Model-1), and the association with ARR-GMR also remained significant even after adjustment for Model-1 and baseline GMR (Model-2).

Conclusion

CACS was significantly associated with rapid progression of BA in CKD patients. This study suggests that VC might affect BA.