Table 3.
Associations of eGFR Categories With Brain Pathological Changes
| Brain MRI Sign | Effect Estimate by eGFR Category (mL/min/1.73 m2)a | |||
|---|---|---|---|---|
| ≥90 | 60–<90 | 30–<60 | <30 | |
| Brain volume | ||||
| Total brain | −0.00 (−0.10 to 0.09) | 0 (ref) | −0.03 (−0.09 to 0.02) | −0.15 (−0.28 to −0.02)c |
| Total cortex | 0.05 (−0.07 to 0.17) | 0 (ref) | −0.01 (−0.07 to 0.06) | −0.21 (−0.36 to −0.06)c |
| Temporal lobe meta-ROI, cm3 | 0.10 (−0.05 to 0.25) | 0 (ref) | 0.02 (−0.06 to 0.10) | −0.16 (−0.35 to 0.02) |
| Cortex excluding temporal lobe meta-ROI, cm3 | 0.04 (−0.08 to 0.1) | 0 (ref) | −0.01 (−0.07 to 0.05) | −0.22 (−0.37 to −0.07)c |
| Brain infarcts | ||||
| Any | 0.61 (0.35 to 1.07) | 1 (ref) | 0.86 (0.64 to 1.16) | 1.10 (0.59 to 2.02) |
| Cortical | 1.07 (0.54 to 2.16) | 1 (ref) | 0.69 (0.46 to 1.04) | 0.74 (0.30 to 1.83) |
| Lacunar | 0.51 (0.25 to 1.04) | 1 (ref) | 1.01 (0.73 to 1.40) | 1.18 (0.63 to 2.24) |
| Brain microhemorrhages | ||||
| Any | 0.88 (0.49 to 1.57) | 1 (ref) | 0.98 (0.73 to 1.32) | 0.75 (0.39 to 1.44) |
| Lobar | 1.25 (0.55 to 2.82) | 1 (ref) | 1.53 (0.98 to 2.38) | 1.51 (0.65 to 3.52) |
| Subcortical | 0.79 (0.41 to 1.52) | 1 (ref) | 0.89 (0.65 to 1.21) | 0.51 (0.28 to 1.05) |
| White matter lesions | ||||
| Log(WMH) volume | −0.02 (−0.21 to 0.16) | 0 (ref) | 0.03 (−0.09 to 0.14) | 0.24 (−0.24 to 0.72) |
| Fractional anisotropy | 0.03 (−0.20 to 0.25) | 0 (ref) | −0.09 (−0.21 to 0.03) | −0.30 (−0.59 to −0.01)c |
| Mean diffusivity, 10–4 mm2/s | 0.04 (−0.17 to 0.25) | 0 (ref) | 0.08 (−0.03 to 0.20) | 0.15 (−0.15 to 0.45) |
Models using inverse probability weighting to account for the selection of participants invited for MRI scans. Models adjusted for age, sex, race, education, apolipoprotein E ε4 status, smoking, body mass index, low-density lipoprotein cholesterol level, hypertension, diabetes, heart failure, stroke, and log(UACR). Continuous outcomes were standardized before regression to have a mean of 0 and SD of 1. For brain volume measurements and log(WMH), models were further adjusted for total intracranial volume. Abbreviations: eGFR, estimated glomerular filtration rate; MRI, magnetic resonance imaging; ROI, region of interest; UACR, urinary albumin-creatinine ratio; WMH, white matter hyperintensities.
Standardized regression coefficient shown for brain volume measures and white matter lesions. Odds ratios shown for brain infarcts and brain microhemorrhages. Values in parentheses are 95% CI. Estimated GFR calculated using the 2012 CKD Epidemiology Collaboration cystatin C equation.
P < 0.05.