Kronik Hemodiyaliz Hastalarında Asemptomatik Mikrokanamalar

Twenty-two of patients (64,7%), 3 of healthy controls (11,5%) and 2 ofhypertensive controls (%8,6) had leukoaraiosis respectively (p=0,000).Conclusion: Asymptomatic CMBs frequently occur in HD patients and their presence mightbe a risk factor for hemorrhagic and ischemic stroke.

📌 3 Key Takeaways

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Objective & Hypothesis:Background: The rate of intracerebral hemorrhage is higher in chronic hemodialysis (HD)patients than in the general population.

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Key Findings & Data:Cerebral microbleeds (CMBs) detected by T2weighted gradient-echo magnetic resonance imaging (GE-MRI) are considered as evidence ofadvanced microangiopathy.

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Conclusion & Impact:Twenty-two of patients (64,7%), 3 of healthy controls (11,5%) and 2 ofhypertensive controls (%8,6) had leukoaraiosis respectively (p=0,000).Conclusion: Asymptomatic CMBs frequently occur in HD patients and their presence mightbe a risk factor for hemorrhagic and ischemic stroke.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Background: The rate of intracerebral hemorrhage is higher in chronic hemodialysis (HD)patients than in the general population. Cerebral microbleeds (CMBs) detected by T2weighted gradient-echo magnetic resonance imaging (GE-MRI) are considered as evidence ofadvanced microangiopathy. The aim of this study is to investigate the frequency of cerebralmicrobleeds (CMBs) in HD patients.Materials and Methods: Study population consisted of volunteer HD patients followed up inŞişli Etfal Education and Research Hospital, Department of Nephrology and healthy andhypertensive controls with similar demographic features. All subjects had cranial GE-MRI fordetecting CMBs.Results: CMBs on GE-MRI were found in 8 of the patient group and in none of the controls(p=0,005). Twenty-two of patients (64,7%), 3 of healthy controls (11,5%) and 2 ofhypertensive controls (%8,6) had leukoaraiosis respectively (p=0,000).Conclusion: Asymptomatic CMBs frequently occur in HD patients and their presence mightbe a risk factor for hemorrhagic and ischemic stroke.

Özet

Amaç: Kronik hemodiyaliz (HD) hastalarında beyin kanaması riski toplumun geneline oranlayüksektir. T2 ağırlıklı gradient eko manyetik rezonans görüntüleme (GE-MRG) ile saptananserebral mikrokanamalar (SMK) ilerlemiş mikroanjiopatinin göstergesi olarak kabuledilmektedir. Bu çalışmanın amacı HD hastalarında serebral mikrokanama sıklığınısaptamaktır.Gereç ve Yöntem: Çalışmaya Şişli Etfal Eğitim ve Araştırma Hastanesi Nefroloji Kliniğindeizlenen ve katılmaya gönüllü olan HD hastaları alındı. Kontrol grupları benzer yaş vecinsiyetteki sağlıklı kişilerden ve hipertansiyon hastalarından oluşturuldu. Tüm hastalarakranial T2 ağırlıklı GE-MRG yapıldı.Sonuçlar: Hasta grubunda 8 kişide SMK görülürken kontrol gruplarında hiç kimsedemikrokanama saptanmadı (p=0,005). Lökoaraiozis hastaların %64,7'sinde, sağlıklı kontrolgrubunun %11,5'inde, hipertansif kontrol grubunun %8,6'sında saptandı (p=0,000).Sonuç: Asemptomatik SMK HD hastalarında sık görülür ve diğer bilinen risk faktörlerininyanı sıra hem iskemik hem hemorajik inme için risk faktörü olabilir.

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Cite This Article

UYSAL, E., FORTA, H., ÜNSAL, A., ACAR, S., NECIOGLU, D. O., AHBAP, E., KENANGİL, G. (2022). Kronik Hemodiyaliz Hastalarında Asemptomatik Mikrokanamalar. Journal of Neurological Sciences (Turkish), Cilt: 30 - Sayı: 2, 314–319. https://ajindex.com/articles/565125

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References (13)

Boulanger JM, Coutts SB, Eliasziw M, Gagnon AJ, Simon JE, Subramaniam S, Sohn CH, Scott J, Demchuk AM f or the VISION study group. Cerebral microhemorrhage p redict new disabling or f atal strokes in p atients with acute ischemic stroke or transient ischemic attack. Stroke 2006;37:911-914
Chan S, Kartha K, Yoon SS, Desmond D W, Hilal SK. Multif ocal hyp ointense cerebral lesions on gradient-echo MR are associated with chronic hyp ertension. AJNR 1996;17:1821-1827
Cho AH, Lee SB, Han SJ, Shon YM, Yang D W, Kim BS. Imp aired kidney f unction and cerebral microbleeds in p atients with acute ischemic stroke. Neurology 2009;73:1645-1648
Fan YH, Zhang L, Lam WM, Mok VCT, Wonk KS. Cerebral microbleeds as a risk f actor f or subsequent intracerebral hemorrhages among p atients with acute ischemic stroke. Stroke 2003;34:2459-2462
Fazekas F, Chawluk B.J, Alavi A, Hurting H.I, Zimmerman R.A. MR signal abnormalities at 1,5 T in Alzheimer's dementia and normal aging. Am J Roentgenol. 1987;149:351-356
Fazekas F, Kleinert R, Roob G, Kleinert G,Kap eller K, Schmidt R, Hartung H.P. Histop athologic analysis nof f oci of signal loss on gradient-echo T2-weighted MR images in p atients with sp ontaneous intracerebral hemorrhage: evidence of microangiop athy- related microbleeds. AJNR. 1999;20:637-642
Greenberg SM, Finklestein SP, Schaef er P W. Petechial hemorrhages accomp anying lobar hemorrhage: detection by gradient-echo MRI. Neurology 1996;46:1751-1754
Ikram AM, Vernooij M W, Hof man A, Niessen WJ, van der Lugt A, Breteler MB. Kidney f unction in related to cerebral small vessel disease. Stroke 2008;39:55-61
Inzitari D, Giordano GP, Ancona AL, Pracucci G, Mascalchi M, Amaducci L. Leukoaraiosis, intracerebral hemorrhage, and arterial hyp ertension. Stroke 1990;21:1419-1423
Iseki K, Kinj o K, Kimura Y, Osawa A, Fukiyama K. Evidence f or high risk of cerebral hemorrhage in chronic dialysis p atients. Kidney International. 1993;44:1086-1090
Iseki K, Fukiyama K. Predictors of stroke in p atients receiving chronic hemodialisis. Kidney International. 1996;50:1672-1675
Kidwell CS, Saver JL, Villablanca JP, Duchwiller G, Fredieu A, Gough KBS, Leary MC, Starkman S, Gobin YP, Jahan R et al. Magnetic resonance imaging detection of microbleeds bef ore thrombolysis: an emerging app lication. Stroke. 2002;33:95-98
Koennecke H.C. Cerebral microbleeds on MRI. Prevalence, associations, and p otential clinical imp lications. Neurology.