Proteinuria Linked With Cerebral Microbleeds in Stroke, TIA Patients
Last Updated: 2010-01-12 19:35:50 -0400 (Reuters Health)
"Spilling of protein in the urine is generally abnormal and is often a reflection of kidney disease or problems with blood vessel function throughout the body," said lead author Dr. Bruce Ovbiagele, of the
Although cerebral microbleeds are clinically "silent," according to the study authors, they are associated with microvascular ischemic disease and may increase the risk of major intracranial bleeding.
In this study, the researchers analyzed the association between proteinuria and cerebral microbleeds in 236 patients hospitalized for an ischemic stroke or TIA. The presence and number of microbleeds -- lesions smaller than 5 mm -- were detected by gradient-echo T2*-weighted magnetic resonance imaging.
Overall, 72 patients (31%) had cerebral microbleeds and 89 (38%) had proteinuria.
Dr. Ovbiagele and his colleagues found that any degree of proteinuria was significantly and independently associated with the presence of cerebral microbleeds (OR 2.33; p = 0.03). Other factors also significantly linked with cerebral microbleeds included female gender, a history of atrial fibrillation, elevated serum homocysteine, and presumed small vessel disease subtype.
Increasing grades of proteinuria correlated with increasing numbers of cerebral microbleeds. The Spearman correlation of proteinuria grade (1 to 4) versus the number of microbleeds was 0.4 (p < 0.001).
Although Dr. Ovbiagele describes the association between proteinuria and cerebral microbleeds as a "strong independent relationship," he also stressed that this was only an association study.
Does the occurrence of one condition lead to the other? That's not yet clear, he said.
But, Dr. Ovbiagele pointed out, screening for protein in the urine is both simple and cheap.
"Proteinuria may serve as an important surrogate marker for development and progression of cerebral microbleeds," he and his colleagues conclude.
Arch Neurol 2010;67:45-50.
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