Purpose: The association between silent brain infarction (SBI) and estimated glomerular filtration rate (eGFR)-based kidney dysfunction has not yet been definitively confirmed. This study aimed to investigate the association in generally healthy adults without a previous history of stroke or overt kidney disease.
Methods: A total of 2,594 subjects who underwent brain MRI as part of health screening were included. SBIs were identified using gradient-recalled echo MRI. Kidney dysfunction was defined as eGFR < 60 ml/min/1.73 m2.
Results: The mean age was 56.8 ± 9.3 years, and 1,422 subjects (54.8%) were male. The mean eGFR level was 81.9 ± 15.4 ml/min/1.73 m2. The prevalence rates of kidney dysfunction and SBI were 5.1% and 7.1%, respectively. A higher proportion of subjects with SBI had kidney dysfunction than subjects without SBI (14.6% vs. 4.4%). The number of SBI lesions tended to increase with the progression of kidney dysfunction (p for trend < 0.001). In multivariate logistic regression analyses, kidney dysfunction was significantly associated with the presence of SBI (adjusted odd ratio = 1.99 to 2.21 in all four models). The same significant association was consistently identified in subgroup analyses using silent lacunar infarction (adjusted odd ratio = 1.71 to 1.87 in all four models).
Conclusion: Kidney dysfunction was found to be an independent risk factor for the presence and number of SBI in generally healthy adults. Physicians treating patients with a decreased creatinine-based eGFR level should try to identify and modify the coexisting risk factors ofstroke followed by SBI.