英国バイオバンクの前向きコホート研究：腎機能障害と脳小血管疾患の関連

This study aims to test the association between multidimensional renal dysfunction biomarkers and cerebral small vessel disease (CSVD) risk using data from the UK Biobank.

The present study encompasses two cohorts. The whole cohort consisted of 43,314 adults without neurological diseases at baseline, who underwent brain magnetic resonance imaging (MRI) during the follow-up period. CSVD imaging markers, including white matter hyperintensity (WMH) volume, mean diffusivity (MD), and fractional anisotropy (FA), were extracted. The sub-cohort consisted of 9786 adults randomly selected from the whole cohort. CSVD MRI features, including the presence of lacunes, white matter hyperintensities (WMHs), enlarged perivascular spaces (EPVS), and cerebral microbleeds (CMBs), as well as CSVD burden score, were assessed.

In the whole cohort, renal dysfunction as reflected by abnormalities in estimated glomerular filtration rates and blood urea nitrogen was associated with increased WMH and MD values and decreased FA values, compared to the healthy group. We observed consistent findings in the sub-cohort: multidimensional renal dysfunction was associated with increased risk of lacunes, WMHs, EPVS, and CMBs, as well as greater severity of CSVD burden.

Our large-scale epidemiological study provides evidence that multidimensional renal dysfunction biomarkers are independently associated with CSVD risk in adults.