Association between Low Estimated Glomerular Filtration Rate and Risk of Cerebral Small-Vessel Diseases: A Meta-Analysis

J Stroke Cerebrovasc Dis. 2016 Mar;25(3):710-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.11.016. Epub 2016 Jan 8.

Abstract

Background: Although chronic kidney disease has been linked to cerebral small-vessel disease (CSVD), a definite relationship between them has not been established. This study assessed whether low estimated glomerular filtration is associated with risk of different subtypes of CSVDs.

Methods: Electronic databases were systematically searched for studies reporting an odds ratio of the association between low estimated glomerular filtration and CSVD risk. Sixteen studies, including 10,534 participants, were identified. A fix effects model was applied and odds ratios (ORs) with 95% confidence intervals were presented.

Results: Overall, risk of CSVDs was greater in individuals with low estimated glomerular filtration (OR = 2.20). Stratified analyses consistently showed significant associations across different subtypes, with pooled OR being greatest in subjects with silent cerebral infarction (SCI) (OR = 2.71) and cerebral microbleed (OR = 2.70). A pooled estimate of studies showing OR as a continuous variable showed results consistent with the former analysis (OR = .98 per standard deviation decrease) in low estimated glomerular filtration.

Conclusions: This study revealed that low estimated glomerular filtration was significantly associated with risk of CSVDs. Low estimated glomerular filtration was most strongly associated with SCI (OR = 2.71) among subtypes of CSVDs.

Keywords: Cerebral small-vessel diseases; chronic kidney impairment; estimated glomerular filtration rate; meta-analysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Small Vessel Diseases / complications*
  • Cerebral Small Vessel Diseases / epidemiology*
  • Databases, Factual / statistics & numerical data
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Odds Ratio
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology