Supplementary Material for: Association of Mild Kidney Dysfunction with Silent Brain Lesions in Neurologically Normal Subjects

Background: Chronic kidney disease (CKD) has been closely associated with stroke. Although a large number of studies reported the relationship between CKD and different types of asymptomatic brain lesions, few comprehensive analyses have been performed for all types of silent brain lesions. Methods: We performed a cross-sectional study involving 1,937 neurologically normal subjects (mean age 59.4 years). Mild CKD was defined as an estimated glomerular filtration rate between 30 and 60 ml/min/1.73 m2 or positive proteinuria. Results: The prevalence of mild CKD was 8.7%. Univariate analysis revealed an association between CKD and all silent brain lesions, including silent brain infarction, periventricular hyperintensity, subcortical white matter lesion, and microbleeds, in addition to hypertension and diabetes mellitus after adjusting for age and sex. In binary logistic regression analysis, the presence of CKD was a significant risk factor for all types of silent brain lesions, independent of other risk factors. Conclusions: These results suggest that mild CKD is independently associated with all types of silent brain lesions, even in neurologically normal subjects.

背景：慢性肾脏病（Chronic kidney disease, CKD）与脑卒中关系密切。尽管已有大量研究报道了CKD与不同类型无症状脑损伤的关联，但目前针对所有类型静默性脑损伤的全面分析仍较为少见。
方法：本研究纳入1937名神经功能正常的受试者（平均年龄59.4岁），开展横断面研究。轻度CKD的定义为估算肾小球滤过率介于30~60 ml/min/1.73 m²，或存在蛋白尿阳性。
结果：轻度CKD的患病率为8.7%。在校正年龄与性别因素后，单因素分析显示，CKD与高血压、糖尿病均存在关联，同时也与各类静默性脑损伤相关，包括静默性脑梗死、脑室周围高信号、皮质下白质病变及脑微出血。二元logistic回归分析结果表明，CKD的存在是所有类型静默性脑损伤的显著危险因素，且独立于其他危险因素。
结论：本研究结果提示，即使在神经功能正常的人群中，轻度CKD仍与各类静默性脑损伤存在独立相关性。