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Brain Vessel Disease May Help Predict ESRD in Diabetes

Study suggests silent cerebral infarction linked to end-stage renal disease and death

FRIDAY, Jan. 29 (HealthDay News) -- Patients with type 2 diabetes who have cerebral microvascular disease are more likely to develop renal disease, according to a study published online Jan. 28 in the Journal of the American Society of Nephrology.

Takashi Uzu, Ph.D., from the Shiga University of Medical Science in Japan, and colleagues studied 608 patients with type 2 diabetes who did not have apparent cerebrovascular or cardiovascular disease or overt nephropathy. Of these, 177 had silent cerebral infarction (SCI), indicative of small vessel disease in the brain, as determined by magnetic resonance imaging.

After a mean of 7.5 years, the researchers found that patients with SCI were at higher risk of end-stage renal disease or death (hazard ratio, 2.44) and any dialysis or doubling of the serum creatinine concentration (hazard ratio, 4.79). Patients with SCI also had significantly greater decreases in the estimated glomerular filtration rate. Having a SCI did not increase the risk for progression of albuminuria, according to the study.

"In conclusion, independent of microalbuminuria, cerebral microvascular disease predicted renal morbidity among patients with type 2 diabetes," Uzu and colleagues write. "The presence of extrarenal microvascular diseases may be a new predictor of the decline in renal function in patients with type 2 diabetes."

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