Abstract: FR-PO420
Asymptomatic Cerebral Microbleeds in Hemodialysis Patients with a History of Stroke
Session Information
- Hemodialysis and Frequent Dialysis - III
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Naganuma, Toshihide, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan
- Takemoto, Yoshiaki, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan
- Uchida, Junji, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan
- Nakatani, Tatsuya, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan
Background
T2*-weighted magnetic resonance imaging (MRI) is an extremely sensitive technique for detecting hemorrhagic lesions. It is especially superior for detection of previously asymptomatic cerebral microbleeds (CMBs), compared to other MRI methods. T2*-weighted MRI has increased the detection rate of CMBs, and as a consequence, the prevalence of CMBs has attracted attention in various patient populations. Clinically, CMBs are a risk factor for stroke, and especially intracerebral hemorrhage, and are also often detected after stroke, including in cases of intracerebral hemorrhage and ischemic cerebrovascular disease. They are also highly prevalent in hemodialysis (HD) patients. In this study, we examined CMBs in HD patients with a history of stroke.
Methods
A cross-sectional study of the prevalence of CMBs and related factors was performed in 309 HD patients (45 with and 264 without a history of stroke) who underwent T2*-weighted MRI at Osaka City University Hospital and affiliated hospitals from 2005 to 2017. The study protocol was conducted in accordance with the Principles of the Declaration of Helsinki and was approved by the ethics committee of Osaka City University Graduate School of Medicine (No. 1415). Informed consent was obtained from all subjects prior to their participation in the study.
Results
CMBs were detected in 103 patients (33.3%). The prevalence of CMBs was significantly higher in patients with a history of stroke compared to those without this history (57.8% vs. 29.2%, p<0.001). In multivariate analysis adjusted for background characteristics, a history of stroke was a significant independent factor related to CMBs (OR: 3.7, 95%CI: 1.7-8.8), as were age and hypertension. A history of intracerebral hemorrhage was more strongly associated with CMBs compared to cerebral infarction (OR: 29.3, 95%CI: 3.4-253.0 vs. OR: 2.1, 95%CI: 0.9-5.3).
Conclusion
Our results show a high prevalence of CMBs in HD patients with a history of stroke, and indicate that a history of stroke is significantly associated with CMBs in HD patients. In particular, a history of intracerebral hemorrhage has a strong association with CMBs.