Factors Of Renal Dysfunction In Patients With Cerebral Small Vessel Disease

Objective:There is a certain correlation between cerebral small vessel disease(CSVD)and renal function abnormality,but the study of related factors is lack of evidence.According to the imaging findings,CSVD is mainly divided into lacunar infarct(LI),white matter hypertensities(WMH),cerebral microbleeds(CMBs)and enlarged perivascularspace(EPVS).The purpuse is to explore the related factors and the potential mechanism of renal dysfunction in patients with CSVD and its subtypes.Methods:801 cases of CSVD during from December 2016 to September 2017were analyzed from the Second Hospital of Hebei Medical University,which were divided into two groups according to the renal function(Cystatin C was more than 1.03mg·L~-11 is dysfunction):renal dysfunction group(case group)cases of 231 cases,normal renal function group(control group)cases of 570 cases.Meanwhile,according to the imaging findings,the subjects were divided into LI group(case group-L:controlgroup-L=51:117),WHMgroup(casegroup-W:control group-M=110:323),CMBs group(case group-C:control group-C=46:66),EPVS group(case group-E:control group-E=24:64).We proceeded the SPSS 21.0 statistical software for analysis and the Logistic regression analysis after collectting the general data and the possible risks of the groups.Results:1.The incidence rate of renal dysfunction was 28.84%in 801 CSVD cases,Logistic regression analysis showed that the age,Homocysteine(Hcy),high sensitivity C-reactive protein(hs-CPR),Lipoprotein(a)[Lp(a)],smoking,hypertension and diabetes were statistically significant(P<0.05),and were independent risks of renal dysfunction in CSVD.2.The incidence rate of renal dysfunction was 30.36%in 168 LI cases,Logistic regression analysis showed that the Hcy and hs-CPR were statistically significant(P<0.05),and were independent risks of renal dysfunction in LI.3.The incidence rate of renal dysfunction was 25.40%in 433 WMH cases,Logistic regression analysis showed that the age,Hcy andhs-CPR were statistically significant(P<0.05),and were independent risks of renal dysfunction in WMH.4.The incidence rate of renal dysfunction was 41.07%in 112 CMBs cases,Logistic regression analysis showed that the hs-CPR,smoking and diabetes were statistically significant(P<0.05),and were independent risks of renal dysfunction in CMBs.5.The incidence rate of renal dysfunction was 27.27%in 88 EPVS cases,Logistic regression analysis showed that the age and smoking were statistically significant(P<0.05),and were independent risks of renal dysfunction in EPVS.Conclusion:The age,Hcy,hs-CPR,Lp(a),smoking,hypertension and diabetes are involved in the pathogenesis of renal dysfunction in CSVD,which Hcy and hs-CRP are relected to the renal dysfunction in LI;the age,Hcy and hs-CPR are connected with the renal dysfunction in WMH;the hs-CPR,smoking and diabetes are relevant to the renal dysfunction inCMBs;the age and smoking are in connection with the renal dysfunction in EPVS.