High Prevalence of Leukoaraiosis in Cerebral Magnetic Resonance Images of Patients on Peritoneal Dialysis
Received 2 November 2006; accepted 22 March 2007. published online 18 May 2007.
Refers to article:
Subclinical Vascular Disease of the Brain in Dialysis Patients
Stephen L. Seliger, Mark J. Sarnak
American Journal of Kidney Diseases
July 2007 (Vol. 50, Issue 1, Pages 8-10) Full Text |
Full-Text PDF (56 KB)
Background
Leukoaraiosis is a term used to define the abnormal appearance of subcortical white matter of the brain by means of neuroimaging and is regarded as an intermediate surrogate of stroke. The goal of this study is to identify the prevalence of leukoaraiosis and analyze predictors of risk of leukoaraiosis.
Study Design
Cross-sectional study.
Setting & Participants
57 peritoneal dialysis (PD) patients without diabetes treated in 3 academic medical-associated dialysis units who did not have a history of cerebrovascular disease or neurological symptoms compared with a convenience sample of 57 age- and sex-matched hypertensive control subjects with normal renal function.
Predictor
End-stage renal disease treated by PD compared with hypertension, adjusted for clinical and laboratory characteristics.
Outcome & Measurement
Hyperintense areas on magnetic resonance imaging T2 high–signal intensity scoring system.
Results
The prevalence of leukoaraiosis was significantly greater in patients on PD therapy than controls (68.4% versus 17.5%; P < 0.001). High T2 signal intensity score in patients on PD therapy compared with controls was significantly higher in the anterior circulation of the brain, relatively sparing the posterior fossa. End-stage renal disease, age, and poor control of blood pressure were significant independent predictors of leukoaraiosis.
Limitations
There is the possibility that biases regarding the selection of enrolled patients had an influence on a study result.
Conclusions
Cerebral magnetic resonance imaging of PD patients without evidence of cerebrovascular disease showed a high prevalence of leukoaraiosis in the anterior circulation of the brain. Old age, poorly controlled hypertension, and the PD procedure itself and/or end-stage renal disease seem to be associated with the presence of leukoaraiosis.
6Yeungnam University School of Medicine, Daegu, Korea.
Address correspondence to Yong-Lim Kim, MD, PhD, Division of Nephrology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
Dae-Joong Kim, MD, PhD, Division of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
ABSTRACT