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Neurology. 2016 Mar 29;86(13):1208-16. doi: 10.1212/WNL.0000000000002527. Epub 2016 Feb 26.

Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults.

Collaborators (748)

Whelton P, Johnson KC, Fine L, Snyder J, Bild D, Bonds D, Cook N, Cutler J, Czajkowski S, Fine L, Kaufmann P, Kimmel P, Launer L, Moy C, Riley W, Ryan L, Snyder J, Yang S, Bee A, Lerner AJ, Rahman M, Still C, Wiggers A, Wright JT Jr, Dancie R, Cushman W, Wall B, Nichols L, Burns R, Martindale-Adams J, Berlowitz D, Clark E, Walsh S, Geraci T, Huff C, Shaw L, Oparil S, Lewis CE, Bradley V, Calhoun D, Glasser S, Jenkins K, Ramsey T, Cheung AK, Beddhu S, Chelune G, Childs J, Gren L, Randall A, Rocco M, Goff D, Rodriguez C, Coker L, Hawfield A, Yeboah J, Crago L, Summerson J, Hege A, Reboussin D, Williamson J, Ambrosius W, Applegate W, Evans G, Foy C, Freedman B, Kitzman D, Pajewski N, Rapp S, Rushing S, Shah N, Vitolins M, Wagenknecht L, Wilson V, Sink KM, Craven B, Craven T, Garcia K, Gaussoin S, Lovato L, Newman J, Amoroso B, Griffin J, Harris D, King M, Lane K, Steinberg D, Ashford D, Cloud L, Felton D, Howard M, Nance P, Perdue L, Puccinelli-Ortega N, Russell L, Walker J, Woolard N, Killeen AA, Lukkari AM, Ringer R, Dillard B, Warren S, Sather M, Pontzer J, Taylor Z, Soliman EZ, Zhang ZM, Li Y, Campbell C, Hensley S, Hu J, Keasler L, Barr M, Taylor T, Bryan RN, Davatzikos C, Nasarallah I, Desiderio L, Elliott M, Borthakur A, Battapady H, Erus G, Smith A, Wang Z, Doshi J, Townsend R, Cohen D, Huan Y, Duckworth M, Ford V, Sexton K, Wright JT Jr, Lerner A, Rahman M, Still C, Bee A, Lee Stokes D, Smith S, Sunshine J, Clampitt M, Smith S, Welch B, Donahue M, Dagley A, Pennell D, Cannistraci C, Merkle K, Lewis J, Sika M, Wright C, Sabati M, Campuzano E, Martin H, Roman A, Cruz J, Nagornaya N, Coker L, Hege A, Maldjian J, Kaminsky S, Fuller D, Jung Y, Oparil S, Lewis B, Wadley V, Jenkins K, Ramsey T, Evanochko W, Roberson G, Corbitt T, Fisher W, Clements C, Weiner D, Wells A, Civiletto A, Aurigemma GP, Bodkin N, Norbash A, Lavoye M, Ellison A, Killiany R, Sakai O, Cheung A, Ambrosius W, Berlowitz D, Cushman W, Oparil S, Wright JT Jr, Goff D, Sink K, Williamson J, Thomas G, Schreiber M Jr, Navaneethan SD, Hickner J, Lioudis M, Marczewski S, Maraschky J, Colman M, Ababy A, Rahman M, Draws P, Kresevic D, Raghavendra PP, Ober S, Mourad R, Tucker L, Schwing B, Sedor J, Horwitz EJ, Schellling J, Humbert L, Tutolo W, Suzanne White, Hughes R, Wright JT Jr, Dobre M, Still CH, Bee A, Williams M, Bhatt U, Agarwal A, Brown M, Ford N, Stratton C, Baxter J, Lykins AA, McKinley Neal A, Hirmath L, Kwame O, Miser WF, Sagrilla C, Johnston J, Anaya A, Rogers K, Ebersbacher D, Long L, Bednarchik B, Wiggers A, Long L, Schnall A, Smith J, Peysha L, Harwell C, Ellington P, Ann Banerji M, Ghody P, Rambaud MV, Townsend R, Cohen D, Huan Y, Duckworth M, Ford V, Leshner J, Sarah VV, Gadegbeku C, Gillespie A, Amoroso S, Pfeffer Z, He J, Chen J, Lustigova E, Dolan J, Sansing L, Malone E, Borja B, Krousel-Wood M, Deichmann R, Ronney P, Muery S, Trapani D, Diamond M, Mulloy L, Anderson H, Stone E, Walker W, Weathers C, McWilliams A, Dulin M, Kuhn L, Standridge S, Preston K, Norton S, Gaines S, Rizvi AA, Sides AW, Hix MM, Hutchinson P, Espiritu J, Feinglos M, Kovalik E, Gedon-Lipscomb G, Evans K, Mason M, Zimmer R, Furst M, Powell J, Bolin P, Zhang J, Phelps P, Garris-Sutton C, Atkinson B, Bryant W, Contreras G, Suarez M, Schulman I, Koggan D, Vassallo J, Peruyera G, Rocco M, Hawfield A, Bethea C, Gilliam L, Pedley C, Zurek G, Baird M, Smoak MM, Williams J, Rogers S, Gordon L, McCorkle-Doomy J, Kennedy E, Adams J, Chamberlain D, Lopez R, Janavs J, Chapman A, Dollar A, Williams O, Han Y, Haley W, Fitzpatrick P, Blackshear J, Shapiro B, Johnson A, Gonzalez H, Harrell A, Robinson J, Tamariz L, Schulman I, Denizard J, Krishnamoorthy D, Greenway F, Church T, Hendrick C, Yoches A, Sones L, Baltazar M, Pemu P, Jones C, Akpalu D, Dember L, Soares D, Yee J, Umanath K, Ogletree N, Thaxton S, Campana K, Sheldon D, MacArthur K, Muhlestein JB, Allred N, Clements B, Dhar R, Meredith K, Le V, Miner E, Orford J, Riessen ER, Ballantyne B, Chisum B, Johnson K, Peeler D, Chertow G, Tamura M, Chang T, Erickson K, Shen J, Stafford RS, Zaharchuk G, Del Cid M, Dentinger M, Sabino J, Sahay R, Telminova EK, Weiner DE, Sarnak M, Chan L, Civiletto A, Heath A, Kantor A, Jain P, Kirkpatrick B, Well A, Yuen B, Chonchol M, Farmer B, Farmer H, Greenwald C, Malaczewski M, Lash J, Porter A, Ricardo A, Rosman RT, Cohan J, Barrera NL, Meslar D, Meslar P, Molly Conroy M, Unruh M, Hess R, Jhamb M, Thomas H, Fazio P, Klixbull E, Komlos-Weimer M, Mandich L, Vita T, Toto R, Van Buren P, Inrig J, Cruz M, Lightfoot T, Wang N, Webster L, Beddhu S, Raphael K, Stults B, Zaman T, Simmons D, Lavasani T, Filipowicz R, Wei G, Miller GM, Harerra J, Christensen J, Giri A, Chen X, Anderton N, Jensen A, Lewis J, Burgner A, Dwyer JP, Schulman G, Herrud T, Leavell E, McCray T, McNeil-Simaan E, Poudel M, Reed M, Sika M, Woods D, Zirkenbach JL, Raj DS, Cohen S, Patel S, Velasquez M, Bastian RS, Wing M, Roy-Chaudhury A, Depner T, Dalyrymple L, Kaysen G, Anderson S, Beddhu S, Nord J, Simmons D, Miller GM, Harerra J, Giri A, Ix JH, Goldenstein L, Miracle CM, Forbang N, Mircic M, Thomas B, Tran T, Rastogi A, Kim M, Rashid M, Lizarraga B, Hocza A, Sarmosyan K, Norris J, Sharma T, Chioy A, Bernard E, Cabrera E, Lopez C, Nunez S, Riad J, Schweitzer S, Sirop S, Thomas S, Wada L, Kramer H, Bansal V, Taylor CE, Segal MS, Hall KL, Kazory A, Gilbert L, Owens L, Poulton D, Whidden E, Blaum C, Wiggins JJ, Gure T, Nyquist L, Robinson E, Qureshi N, Ferguson K, Haider S, James M, Jones C, Renfroe K, Seay A, Weigart C, Thornley-Brown D, Rizik D, Cotton B, Fitz-Gerald M, Grimes T, Johnson C, Kennedy S, Mason C, Rosato-Burson L, Willingham R, Calhoun D, Judd E, Breaux-Shropshire T, Cook F, Medina J, Lewis J, Brantley R, Brouilette J, Glaze J, Hall S, Hiott N, Tharpe D, Boddy S, Mack C, Johnson KC, Womack C, Griffin B, Hendrix C, Johnson K, Jones L, Towers C, Punzi H, Cassidy K, Schumacher K, Irizarry C, Colon I, Colon-Ortiz P, Colon-Hernandez P, Carrasquillo M, Vazquez N, Sosa-Padilla M, Cintron-Pinero A, Ayala M, Pacheco O, Rivera C, Sotomayor-Gonzalez I, Claudio J, Lazaro J, Arce M, Heres L, Perez A, Tavarez-Valle J, Arocho F, Torres M, Vazquez M, Aurigemma GP, Takis-Smith R, Andrieni J, Bodkin N, Chaudhary K, Hu P, Kostis J, Cosgrove N, Bankowski D, Boleyn M, Casazza L, Giresi V, Patel T, Squindo E, Wu Y, Wofford M, Flessner M, Adair C, Asher J, Loope D, Cobb R, Venegas R, Bigger T, Donovan D, Lopez-Jimenez C, Tirado A, Bigger T, Getaneh A, Tang R, Durant S, Bigger T, Maurer M, Teruya S, Helmke S, Alvarez J, Campbell R, Pisoni R, Sturdivant R, Counts C, Hunt V, Spillers L, Brautigam D, Kitchen T, Gorman T, Sayers J, Button S, Chiarot J, Fischer R, Lyon M, Resnick M, Servilla K, Vigil D, Barrett T, Meyers M, Sweeney ME, Johnson R, McConnell S, Shahid Salles K, Watson F, Maher M, Schenk C, Whittington L, Swartz S, Conlin P, Williams J, Alexis G, Gomes H, Lamkin R, Rosendorff C, Atlas S, Kherada N, Gonzalez W, Barcham S, John J, Rehman S, Basile J, Kagan M, Baig H, Ham D, Saklayen M, Yap J, Miller C, Neff H, Gappy S, Raman A, Rau S, Berchou V, Jones E, Olgren E, Sastrasinh S, Fiore J, Kutza M, Shorr R, Bavry A, Mount R, Segal M, Thoms J, Waddell D, Dunn H, Hunter J, Stinson S, Taylor A, Bates J, Cowart J, Ragbir S, Anderson C, Wright C, Kirchner K, Stubbs J, Hinton A, Spencer AK, Sharma S, Wiegmann T, Goel A, Khan A, Savin V, Mehta S, Krause M, Simmons D, Straub K, Dishongh K, Wall B, Adabala J, Childress R, Cushman W, Gyamlani G, Niakan A, Thompson C, Moody J, Whittle J, Barnas G, Wolfgram D, Cortese H, Roumie C, Hung A, Niesner K, Wharton J, Katz L, Brock G, Richardson E, Dixon T, Holland J, Zias A, Spiller C, Felicetta J, Baker P, Rehman S, Carrel P, Watnick S, Weiss J, Johnston T, Walczyk J, Giddings S, Klein A, Rowe C, Conwill L, Vargo K, Waidmann K, Papademetriou V, Elkhoury JP, Amodeo S, Bloom M, Gregory B, Hare K, Goldfarb-Waysman D, Treger R, Knibloe K, Ishani A, Slinin Y, Olney C, Fanti P, Bansal S, Dunnam M, Dyer C, Hu LL, Zarate-Abbott P.

Abstract

OBJECTIVE:

To determine the relation between markers of kidney disease-estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (UACR)-with cerebral blood flow (CBF) and white matter volume (WMV) in hypertensive adults.

METHODS:

We used baseline data collected from 665 nondiabetic hypertensive adults aged ≥50 years participating in the Systolic Blood Pressure Intervention Trial (SPRINT). We used arterial spin labeling to measure CBF and structural 3T images to segment tissue into normal and abnormal WMV. We used quantile regression to estimate the association between eGFR and UACR with CBF and abnormal WMV, adjusting for sociodemographic and clinical characteristics.

RESULTS:

There were 218 participants (33%) with eGFR <60 mL/min/1.73 m(2) and 146 participants (22%) with UACR ≥30 mg/g. Reduced eGFR was independently associated with higher adjusted median CBF, but not with abnormal WMV. Conversely, in adjusted analyses, there was a linear independent association between UACR and larger abnormal WMV, but not with CBF. Compared to participants with neither marker of CKD (eGFR ≥60 mL/min/1.73 m(2) and UACR <30 mg/g), median CBF was 5.03 mL/100 g/min higher (95% confidence interval [CI] 0.78, 9.29) and abnormal WMV was 0.63 cm(3) larger (95% CI 0.08, 1.17) among participants with both markers of CKD (eGFR <60 mL/min/1.73 m(2) and UACR ≥30 mg/g).

CONCLUSIONS:

Among nondiabetic hypertensive adults, reduced eGFR was associated with higher CBF and higher UACR was associated with larger abnormal WMV.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01206062.

PMID:
26920359
PMCID:
PMC4818564
DOI:
10.1212/WNL.0000000000002527
[Indexed for MEDLINE]
Free PMC Article

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