Cystatin C and Subclinical Brain Infarction

Seliger, Stephen L.; Longstreth, W. T.; Katz, Ronit; Fried, Linda F.; Shlipak, Michael G.; Stehman‐Breen, Catherine; Newman, Anne B.; Sarnak, Mark J.; Gillen, Daniel L.; Bleyer, Anthony J.; Siscovick, David S.

doi:10.1681/asn.2005010006

Cited by 124 publications

(110 citation statements)

References 30 publications

(35 reference statements)

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“…A consensus has emerged that treatment with renin-angiotensin-aldosterone system blockers, such as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, has a specific renoprotective effect, but the direct efficacy of such regimens on SVD progression has not yet been proven. 22,23 According to previous reports that demonstrated the association between kidney dysfunction and SVD, [8][9][10][11][12][13] it can be also considered that the deterioration of kidney function takes part in cerebral atrophy through the SVD progress. As SVD mainly affects deep perforating arterioles, it was expected that decreased GFR might relate more closely to periventricular atrophy than cortical atrophy.…”

Section: Resultsmentioning

confidence: 99%

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Yakushiji

Nanri

Hirotsu³

et al. 2010

Hypertens Res

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The relationship between kidney dysfunction, such as chronic kidney disease (CKD), and brain morphology has attracted increasing attention, but the association between kidney dysfunction and cerebral atrophy has yet to be determined. The purpose of this study was to clarify the relationship between kidney function and a substantial degree of cerebral atrophy. A total of 610 consecutive Japanese adults without neurological disorders who had undergone health screening tests of the brain were studied prospectively. Magnetic resonance imaging was performed using a 1.5-T scanner. Using a computer-assisted processing system, the percentage of cerebrum atrophy (%Cerebrum atrophy) was calculated as an index of cerebral atrophy. Atrophy was defined as 42 s.d.s below the mean %Cerebrum atrophy. The glomerular filtration rate (GFR) was estimated using the revised equations for estimated GFR from serum creatinine in Japan. Kidney function variables included the GFR value and the prevalence of subjects with GFR o60 ml min À1 per 1.73 m 2 . Cerebral atrophy was found in 25 (4.1%) cases. Univariate analysis showed that age, male sex, hypertension, each kidney function variable, white matter hyperintensities and lacunae were associated with cerebral atrophy. On logistic regression analysis, GFR (odds ratio (OR), 0.64; 95% confidence interval (CI), 0.42-0.98) and GFR o60 ml min À1 per 1.73 m 2 (OR, 5.93; 95% CI,) were significantly associated with cerebral atrophy. On subanalysis, GFR o60 ml min À1 per 1.73 m 2 was significantly associated with cortical atrophy (OR, 3.23; 95% CI, 1.15-9.11). Decreased GFR was significantly associated with cerebral atrophy, indicating that treatment of CKD may control age-related degenerative processes of the brain.

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Section: Resultsmentioning

confidence: 99%

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Yakushiji

Nanri

Hirotsu³

et al. 2010

Hypertens Res

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“…Among CKD patients, the prevalence of silent infarcts is inversely reported to kidney function as measured by cystatin C in the Cardiovascular Health Study (38); among hemodialysis patients in another study, the prevalence was 49 percent, or 5 times more common than in control subjects (39). Silent strokes are associated with increased risk of subsequent clinically evident stroke, cognitive and physical decline, and incident dementia (36,37,40) in both the general and CKD/dialysis populations (39,41).…”

Section: Subclinical Cerebrovascular Disease: Silent Infarcts and Whimentioning

confidence: 99%

Cognitive Impairment in the Aging Dialysis and Chronic Kidney Disease Populations: An Occult Burden

Murray

2008

Advances in Chronic Kidney Disease

344

241

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The heavy burden of cognitive impairment in hemodialysis and chronic kidney disease patients has only recently become recognized. Up to 70 percent of hemodialysis patients ages 55 years and older have moderate to severe chronic cognitive impairment, yet it is largely undiagnosed. Recent studies describe the strong graded relation between estimated glomerular filtration rate (eGFR) and cognitive function in CKD patients. The process of conventional hemodialysis may induce recurrent episodes of acute cerebral ischemia, which in turn may contribute to acute decline in cognitive function during dialysis. Thus the worst time to communicate with dialysis patients may be during the hemodialysis session. Both symptomatic and occult, subclinical ischemic cerebrovascular disease appear to play a large role in a proposed model of accelerated vascular cognitive impairment in these populations. Severe cognitive impairment or dementia among hemodialysis patients is associated with an approximately two-fold increased risk of both mortality and dialysis withdrawal. Pre-dialysis cognitive screening and adding dementia to the list of comorbidities on Form 2728 would provide critical information regarding the benefit versus risks of receiving dialysis. It could also improve quality of care and outcomes by raising clinician's awareness of the potential effects of cognitive impairment on medication, fluid, and dietary compliance, and ability to make advance directive decisions among dialysis patients. While much remains to be learned regarding the pathophysiology of cognitive impairment in kidney disease, the public health implications of this substantial burden are immediate.

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“…Retrospective studies on existing cohorts very rapidly extended these findings to the entire population and in particular to the elderly. CysC was significantly associated with all cause mortality (209,(217)(218)(219)(220)(221)(222)(223), cardiovascular mortality (209, 217-219, 222, 223), myocardial infarction (209,224), cerebrovascular accident (209,225) and peripheral arterial disease (226). Whilst the association with all cause or cardiovascular mortality was found systematically, other authors failed to find relationships between CysC concentrations and non-coronary vascular accidents (218) mostly in middle-aged men (227).…”

Section: Future Perspectives For Cysc Applications Cysc As a Cardiovamentioning

confidence: 99%

“…Whilst the association with all cause or cardiovascular mortality was found systematically, other authors failed to find relationships between CysC concentrations and non-coronary vascular accidents (218) mostly in middle-aged men (227). These relationships between cardiovascular disease and increased CysC concentrations have been described both in cohorts or sub-groups of patients selected on the basis of a past history of cardiovascular disease (216,217,219,221,225,226) and in patients without cardiovascular history (220, 222-224, 228, 229). Some also consider that increased CysC values may be associated with morphological cardiac abnormalities, such as left ventricular hypertrophy or left ventricular dysfunction on echocardiography (228), functional abnormalities, such as heart failure (230), or poor exercise tolerance (231).…”

Section: Future Perspectives For Cysc Applications Cysc As a Cardiovamentioning

confidence: 99%

Cystatin C: current position and future prospects

Séronie-Vivien

Delanaye

Piéroni³

et al. 2008

Clinical Chemistry and Laboratory Medicine

163

145

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Cystatin C is a low-molecular-weight protein which has been proposed as a marker of renal function that could replace creatinine. Indeed, the concentration of cystatin C is mainly determined by glomerular filtration and is particularly of interest in clinical settings where the relationship between creatinine production and muscle mass impairs the clinical performance of creatinine. Since the last decade, numerous studies have evaluated its potential use in measuring renal function in various populations. More recently, other potential developments for its clinical use have emerged. This review summarises current knowledge about the physiology of cystatin C and about its use as a renal marker, either alone or in equations developed to estimate the glomerular filtration rate. This paper also reviews recent data about the other applications of cystatin C, particularly in cardiology, oncology and clinical pharmacology. Clin Chem Lab Med 2008;46:1664-86.

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Cystatin C and Subclinical Brain Infarction

Cited by 124 publications

References 30 publications

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Marked cerebral atrophy is correlated with kidney dysfunction in nondisabled adults

Cognitive Impairment in the Aging Dialysis and Chronic Kidney Disease Populations: An Occult Burden

Cystatin C: current position and future prospects

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