Risk factors for and predictors of intracranial artery stenosis in patients with end-stage kidney disease

Purpose To explore the risk factors for and predictors of intracranial artery stenosis (ICAS) in patients with end-stage kidney disease (ESKD). Methods A cross-sectional study of 178 patients who were hospitalized in Department of Nephrology, Huadong Hospital, Fudan University, Shanghai, China between June 2017 and March 2021 and underwent brain MRA during hospitalization was conducted. ICAS was defined as intracranial artery stenosis exceeding 50%. We included 45 patients as the ICAS group and 26 patients without ICAS as the control group. Univariate analysis was used to explore different indicators. Binary logistic regression analysis further explored whether the different factors were independent risk factors, the ROC curve was used to explore the predictive value of various indicators for ICAS in patients with ESKD. Results In this analysis, the average age of patients was 67.61 ± 11.62 years, and the eGFR was 7.00 ± 2.95 ml/min/1.73 m ² . Binary logistic regression analysis showed that total cholesterol (TC) (OR=3.372, 95% CI: 1.497-7.593) and low-density lipoprotein (LDL) (OR=3.795, 95% CI: 1.550-9.289) were independently associated with ICAS. ROC analysis demonstrated that TC (71.4%, 72%) with a cutoff value of 3.870 mmol/l and LDL (75.6%, 69.6%) with a cutoff value of 2.025 mmol/l had strong predictive value for ICAS in patients with ESKD. Conclusion In patients with ESKD, TC and LDL were associated with ICAS after adjusting for covariates and have strong predictive value for ICAS.