Cerebral Infarction May Predict Renal Decline

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The presence of silent cerebral infarction (SCI) may predict an increased risk for worsening kidney function in patients with type 2 diabetes, according to a study.

Researchers led by Takashi Uzu, MD, of Shiga University School of Medicine in Otsu, Japan, studied 608 patients with type 2 diabetes (aged 30-75 years), all initially free of symptomatic stroke, heart disease, or kidney disease.

Magnetic resonance imaging of the brain revealed that, at baseline, 177 patients (29%) of the patients had SCI, small areas of brain damage that was not severe enough to cause overt stroke symptoms.

After a mean follow-up period of 7.5 years, patients with SCI were 2.4 times more likely to die or develop end-stage renal disease compared with those who had normal brain MRI scans, the investigators reported in the Journal of the American Society of Nephrology (2010; published online ahead of print). They also had a nearly fivefold increased risk of a doubling of serum creatinine.

The authors concluded that patients with type 2 diabetes and SCI had worse renal morbidity compared with subjects without SCI. “The presence of extrarenal microvascular diseases may be a new predictor of the decline in renal function in patients with type 2 diabetes,” they wrote.

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