# Association Between Renal Dysfunction and Cerebral Small Vessel Disease: A Prospective Cohort Study From the UK Biobank

## TL;DR

This study finds a link between kidney dysfunction and brain small vessel disease using data from thousands of adults in the UK Biobank.

## Contribution

It is the first large-scale study to show that multiple kidney dysfunction markers are independently associated with cerebral small vessel disease risk.

## Key findings

- Renal dysfunction was linked to increased white matter hyperintensity and mean diffusivity in brain imaging.
- Kidney issues were also associated with a higher risk of lacunes, enlarged perivascular spaces, and cerebral microbleeds.
- The severity of cerebral small vessel disease burden was greater in individuals with renal dysfunction.

## Abstract

This study aims to test the association between multidimensional renal dysfunction biomarkers and cerebral small vessel disease (CSVD) risk using data from the UK Biobank.

The present study encompasses two cohorts. The whole cohort consisted of 43,314 adults without neurological diseases at baseline, who underwent brain magnetic resonance imaging (MRI) during the follow‐up period. CSVD imaging markers, including white matter hyperintensity (WMH) volume, mean diffusivity (MD), and fractional anisotropy (FA), were extracted. The sub‐cohort consisted of 9786 adults randomly selected from the whole cohort. CSVD MRI features, including the presence of lacunes, white matter hyperintensities (WMHs), enlarged perivascular spaces (EPVS), and cerebral microbleeds (CMBs), as well as CSVD burden score, were assessed.

In the whole cohort, renal dysfunction as reflected by abnormalities in estimated glomerular filtration rates and blood urea nitrogen was associated with increased WMH and MD values and decreased FA values, compared to the healthy group. We observed consistent findings in the sub‐cohort: multidimensional renal dysfunction was associated with increased risk of lacunes, WMHs, EPVS, and CMBs, as well as greater severity of CSVD burden.

Our large‐scale epidemiological study provides evidence that multidimensional renal dysfunction biomarkers are independently associated with CSVD risk in adults.

In the whole cohort, renal dysfunction was associated with increased WMH and MD values, and decreased FA values, which suggests a higher risk of CSVD. Consistent findings were observed in the sub‐cohort: renal dysfunction was associated with increased risk of lacunes, WMHs, EPVS, and CMBs, as well as greater severity of CSVD burden.