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Kidney Week

Abstract: SA-PO1220

Association of Leukocyte Counts and Hemoglobin Levels with White Matter Hyperintensities in Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Liu, Yuhsin, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Huang, TengHui, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Lin, Ming-Yen, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Kuo, Mei-Chuan, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Chiu, Yi-Wen, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Hwang, Shang-Jyh, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Wu, Ping-Hsun, Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
  • Lin, Yi-Ting, Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
Background

Chronic kidney disease (CKD) is increasingly recognized for its association with cognitive dysfunction and brain damage, potentially mediated by anemia and chronic inflammation. This study examined associations between complete blood count (CBC), particularly leukocyte counts and hemoglobin levels, and white matter hyperintensities (WMHs) in CKD patients.

Methods

This study enrolled 1,738 CKD patients who underwent CBC and brain magnetic resonance imaging (MRI) assessments. WMHs were scored using the Fazekas scale for periventricular and deep lesions. Patients were categorized as early-stage (CKD stage 1-2; n=181) or advanced-stage (CKD stage 3-5; n=1,557). Multivariable-adjusted ordinal regression models analyzed the relationships between CBC parameters and Fazekas scores, with additional analyses for neutrophil and lymphocyte counts.

Results

Higher leukocyte counts and lower hemoglobin levels correlated with more severe periventricular WMHs in all CKD patients (leukocyte: odds ratio [OR] 1.07, 95% confidence interval [CI] 1.03–1.11, p=0.001; hemoglobin: OR 0.92, 95% CI 0.88–0.97, p=0.002) and specifically in advanced CKD (leukocyte: OR 1.07, 95% CI 1.03–1.12, p=0.001; hemoglobin: OR 0.94, 95% CI 0.89–1.00, p=0.033). Elevated neutrophil counts were significantly associated with worse periventricular (OR 1.046, 95% CI 1.01–1.08, p=0.011) and deep WMHs (OR 1.044, 95% CI 1.00–1.08, p=0.013)but no lymphocyte counts. Platelet counts showed no significant association in our study.

Conclusion

Elevated leukocyte counts, particular increased neutrophil counts, and decreased hemoglobin levels, are associated with severe WMHs. Our study results highlight the role of inflammation and anemia in CKD-related cerebrovascular damage.

Digital Object Identifier (DOI)