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Renal dysfunction is associated with deep cerebral microbleeds but not white matter hyperintensities in patients with acute intracerebral hemorrhage

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Abstract

Kidney disease is a risk factor for cerebral microangiopathy and spontaneous intracerebral hemorrhage (ICH). We aimed to determine the association of renal dysfunction (RD) with MRI correlates of different patterns of cerebral microangiopathies including cerebral microbleeds (CMB) and white matter lesions (WML) in patients with ICH. In a prospectively collected, single-center cohort of ICH patients, glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease equation. We classified the renal function in five categories: category 1 (eGFR ≥90 mL/min/1.73 m2), category 2 (eGFR 60–89), category 3 (eGFR 30–59), category 4 (eGFR 15–29), and category 5 (eGFR <15) and dichotomized at an eGFR of 60. Number, location, and extent of CMB and WML were measured on MRI. ICH and CMB locations were classified as lobar or deep. 97 ICH patients with MRI (mean age 65.9 ± 13.9 years) were included. Intracerebral hemorrhage was lobar in 52.6 %. Median eGFR was 85.8 mL/min/1.73 m2 (IQR 34.3). Renal dysfunction was present in 12.4 % of the patients. At least one CMB was present in 57.7 % of patients, WML were even more frequent (97.7 %). Age and impaired renal function were factors independently associated with the presence of CMB. The presence of CMB was independently associated with the number and extent of WML. RD is a frequent comorbidity in patients with ICH. Associations of RD with hypertension and with CMB in deep location suggest a predominant impact of RD on deep rather than on lobar microangiopathy.

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Conflicts of interest

RV has received consulting honoraria, research support, travel grants, and speakers’ honoraria from Bayer HealthCare, BoehringerIngelheim, BMS Pfizer, Daiichi Sankyo, Roche Diagnostics, St. Jude Medical, and Sanofi Aventis. TR received consulting honoraria and speakers’ honoraria from BoehringerIngelheim and BMS Pfizer. CW, MM, ML, SH, and SS report no disclosures.

Ethical standards

This study was approved by the appropriate ethic committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Neurology, University of Heidelberg, INF 400, 69120, Heidelberg, Germany

    Mona Laible, Solveig Horstmann, Christian Wegele, Timolaos Rizos & Roland Veltkamp

  2. Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany

    Markus Möhlenbruch

  3. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany

    Svenja Schüler

  4. Department of Internal Medicine-I, University of Heidelberg, Heidelberg, Germany

    Markus Zorn

  5. Department of Stroke Medicine, Imperial College London, London, UK

    Roland Veltkamp

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  1. Mona Laible
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  2. Solveig Horstmann
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  3. Markus Möhlenbruch
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  4. Christian Wegele
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Correspondence to Mona Laible.

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Laible, M., Horstmann, S., Möhlenbruch, M. et al. Renal dysfunction is associated with deep cerebral microbleeds but not white matter hyperintensities in patients with acute intracerebral hemorrhage. J Neurol 262, 2312–2322 (2015). https://doi.org/10.1007/s00415-015-7840-2

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  • DOI: https://doi.org/10.1007/s00415-015-7840-2

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