| [ Summary ] |
Chronic kidney disease (CKD) and cerebrovascular disease are global public health concerns and are known to share similar pathophysiological mechanisms. Considerable evidence exhibiting an association between kidney functions and adverse cerebrovascular events was found in patients with CKD. Recent studies have also indicated a close link between kidney dysfunction and small vessel disease（SVD）related brain lesions. It was initially found that dialysis patients have high rates of SVD-related lesions, and subsequently found that these findings were very common in CKD patients. Cerebral SVD is associated with increased risk of stroke and dementia in both general and CKD populations. Moreover, prospective cohort studies have suggested that silent brain infarcts, including SVD-related lesions, were independent risk factors for the progression of kidney dysfunction in patients with CKD. The underlying mechanism of these findings remains unclear. However, similar hemodynamic properties in the vascular beds of the brain and kidneys may indicate a close relationship between kidney dysfunction and cerebral SVD. Furthermore, endothelial dysfunction, frequently found in CKD, may cause or accelerate development of cerebral SVD. Impaired microcirculation and blood-brain barrier breakdown may be related to the development of cerebral SVD. |