Читать книгу Recent Advances in Dialysis Therapy in Japan - Группа авторов - Страница 55

SBI is considered to be an independent risk factor for CI and ICH in the general population [6]. In most cases, SBI is found as a lacunar infarction, the most common form of subcortical infarction, which was defined by Fisher as a small, deep CI caused by occlusion of small penetrating cerebral arteries [9]. Magnetic resonance imaging (MRI) studies have shown that the incidence of SBI among the general population is 10.6–12.9% [6, 14, 15]. We and others have reported a high prevalence of SBI of 35.7–55.5% in HD patients [13, 16]. We have also reported a higher incidence of SBI in HD patients compared with controls using MRI (48.8 vs. 9.6%) [13]. Our subsequent longitudinal study showed that patients with SBI had significantly higher cerebral and cardiovascular morbidity compared to those without SBI [17]. Moreover, Sato et al. [16] also found that combination of SBI and increased carotid intima-media thickness is an independent predictor of cardiovascular events and all-cause mortality in chronic HD patients.

Thus, in dialysis patients, SBI is a risk factor for stroke and for cardiovascular events as a whole. Systemic arteriolosclerotic and atherosclerotic vascular changes are likely to be advanced in dialysis patients with SBI, which may also increase the risk of other cardiovascular and cerebral events.