Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 54

Recent studies have shown that asymptomatic cerebral small vessel disease, including silent brain infarction (SBI), white matter hyperintensities (WMHs), and cerebral microbleeds (CMBs), is related to the future onset of stroke [5–7]. Cerebral small-vessel disease is caused by microvascular damage to the small penetrating arteries of the middle cerebral artery, including arteriolosclerosis, fibrinoid necrosis, and lipohyalinosis attributed to advanced age, hypertension, and other reasons [7–10]. SBI is thought to occur due to cerebral small vessel occlusion caused by vascular necrosis [8, 9], CMB vascular breakdown is caused by vascular fragility [10], and WMH chronic ischemia is caused by decreased perfusion [7]. A higher frequency of cerebral small-vessel disease in dialysis patients than in healthy subjects has been reported, and in our study [11–13] with hemodialysis patients the frequency was also significantly higher than that in healthy subjects (Fig. 2). Further evidence on small-vessel disease needs to be accumulated in order to prevent future strokes in these patients.