Kidney Week

Abstract: FR-PO287

Albuminuria Is a Biomarker for Severity of White Matter Hyperintensities on Brain MRI in a General Elderly Population of Japanese: The Hisayama Study

Session Information

• CKD: Epidemiology and Risk Factors
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Yamasaki, Keisuke, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Keisuke Yamasaki,

• Hata, Jun, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Jun Hata,

• Hirabayashi, Naoki, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Naoki Hirabayashi,

• Furuta, Yoshihiko, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Yoshihiko Furuta,

• Ohara, Tomoyuki, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Tomoyuki Ohara,

• Hirakawa, Yoichiro, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Yoichiro Hirakawa,

• Nakano, Toshiaki, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Toshiaki Nakano,

• Kitazono, Takanari, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Takanari Kitazono,

• Ninomiya, Toshiharu, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Toshiharu Ninomiya,

Background

White matter hyperintensities (WMH), which are often observed in brain magnetic resonance imaging (MRI) among the elderly, have been reported to be associated with an increased risk of symptomatic stroke. Albuminuria and reduced estimated glomerular filtration rate (eGFR) have been acknowledged to be independent risk factors for stroke, but the studies addressing the association of albuminuria and reduced eGFR with WMH volume in general Japanese elderly populations are limited.

Methods

A total of 1,214 community-dwelling Japanese subjects aged ≥65 years underwent brain MRI scans and a comprehensive health examination in 2012. Urine albumin-creatinine ratio (UACR) was categorized as normoalbuminuria (<30 mg/g)，microalbuminuria (30-299 mg/g), and macroalbuminuria (≥300 mg/g). Subjects with normoalbuminuria were further divided into the following tertile categories: low-normal (≤7.3 mg/g), medium-normal (7.4-12.8 mg/g), and high-normal (12.9-29.9 mg/g). Reduced eGFR was defined as eGFR <60 mL/min per 1.73 m2. The severity of WMH was evaluated with the ratio of WMH volume to intracranial volume (WMHV/ICV). The association of UACR levels or reduced eGFR with WMHV/ICV ratio was estimated using the analysis of covariance.

Results

The age- and sex-adjusted geometric mean value of the WMHV/ICV ratio increased significantly with higher UACR levels (low-normal: 0.19%, medium-normal: 0.21%, high-normal: 0.25%, microalbuminuria: 0.25%; macroalbuminuria: 0.30%; P for trend <0.001). This association remained significant after additional adjustment for hypertension, diabetes mellitus, hypercholesterolemia, body mass index, eGFR, electrocardiogram abnormalities, smoking habits, alcohol intake, regular exercise, and cerebrovascular lesions on MRI (P for trend =0.001). In contrast, there was no clear association between reduced eGFR and WMHV/ICV ratio.

Conclusion

Our data suggest that albuminuria, even within the normal range, is a useful biomarker for estimating the severity of WMH in a general elderly population of Japanese.