PMID- 20536949
OWN - NLM
STAT- MEDLINE
DCOM- 20101105
LR  - 20131121
IS  - 1464-5491 (Electronic)
IS  - 0742-3071 (Linking)
VI  - 27
IP  - 5
DP  - 2010 May
TI  - Relationship between chronic kidney disease and silent cerebral infarction in 
      patients with Type 2 diabetes.
PG  - 538-43
LID - 10.1111/j.1464-5491.2010.02922.x [doi]
AB  - AIMS: Silent cerebral infarction (SCI) is an independent risk factor for future 
      symptomatic stroke. Although the prevalence of SCI is closely related to kidney 
      function in non-diabetic individuals, evidence is lacking whether albuminuria 
      and/or reduced estimated glomerular filtration rate (eGFR) independently increase 
      the risk of SCI in diabetic patients. We therefore examined the relationships 
      between albuminuria, eGFR and SCI in patients with Type 2 diabetes mellitus 
      (T2DM). METHODS: We studied 786 T2DM patients with an eGFR > or = 15 ml/min 
      1.73/m(2), including 337 women and 449 men [mean (+/- sd), age 65 +/- 11 years]. 
      All patients underwent cranial magnetic resonance imaging (MRI) to detect SCI. 
      GFR was estimated using the modified three-variable equation for Japanese 
      subjects. Albuminuria was defined as a first morning urinary 
      albumin-to-creatinine ratio (ACR) > or = 30 mg/g. RESULTS: SCI was detected in 
      415 (52.8%) of the subjects. The prevalence of SCI was significantly associated 
      with both elevated ACR and decreased eGFR in univariate analysis. In multivariate 
      logistic regression analysis, urinary ACR remained independently associated with 
      SCI after adjusting for conventional cardiovascular risk factors [odds ratio (OR) 
      of urinary ACR per logarithmical value: 1.89, 95% confidence interval (CI) = 
      1.41-2.51, P < 0.001]; however, eGFR was no longer significantly associated with 
      SCI (OR per ml/min 1.73/m(2) = 0.99, 95% CI = 0.98-1.00, P = 0.095). CONCLUSION: 
      In conclusion, albuminuria but not decreased eGFR may be an independent predictor 
      of prevalent SCI in patients with T2DM.
FAU - Bouchi, R
AU  - Bouchi R
AD  - Division of Nephrology and Hypertension, Department of Medicine, Diabetes Centre, 
      Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
FAU - Babazono, T
AU  - Babazono T
FAU - Yoshida, N
AU  - Yoshida N
FAU - Nyumura, I
AU  - Nyumura I
FAU - Toya, K
AU  - Toya K
FAU - Hayashi, T
AU  - Hayashi T
FAU - Hanai, K
AU  - Hanai K
FAU - Tanaka, N
AU  - Tanaka N
FAU - Ishii, A
AU  - Ishii A
FAU - Iwamoto, Y
AU  - Iwamoto Y
LA  - eng
PT  - Journal Article
PL  - England
TA  - Diabet Med
JT  - Diabetic medicine : a journal of the British Diabetic Association
JID - 8500858
RN  - 0 (Albumins)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Aged
MH  - Albumins/analysis
MH  - Albuminuria/diagnosis
MH  - Cerebral Infarction/complications/*epidemiology/physiopathology
MH  - Creatinine/urine
MH  - Diabetes Mellitus, Type 2/*complications/physiopathology
MH  - Diabetic Nephropathies/*complications/physiopathology
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Renal Insufficiency, Chronic/*complications/physiopathology
EDAT- 2010/06/12 06:00
MHDA- 2010/11/06 06:00
CRDT- 2010/06/12 06:00
PHST- 2010/06/12 06:00 [entrez]
PHST- 2010/06/12 06:00 [pubmed]
PHST- 2010/11/06 06:00 [medline]
AID - DME2922 [pii]
AID - 10.1111/j.1464-5491.2010.02922.x [doi]
PST - ppublish
SO  - Diabet Med. 2010 May;27(5):538-43. doi: 10.1111/j.1464-5491.2010.02922.x.