Objectives: To investigate the association of kidney function with the total burden of
Cerebral Small Vessel Disease (CSVD) in primary Intracerebral Hemorrhage (pICH).
Methods: Cerebral magnetic resonance imagings of consecutively enrolled pICH patients were reviewed
to assess for lacunes, White Matter Hyperintensity (WMH), Cerebral Microbleeds (CMBs)
and Enlarged Perivascular Spaces (EPVS). Minor refinements to the CSVD score, namely modified
CSVD score 1 and 2, were made by incorporating different weightings of CSVD markers.
Kidney function was assessed using the estimated Glomerular Filtration Rate (eGFR). We used ordinal
regression analysis to assess the association of kidney function with the CSVD score and
Results: In the 108 patients included, the presence of lacunes, CMBs, MWH and basal ganglia
EPVS>10 was 27.8%, 67.6%, 47.2% and 35.2%, respectively. In multivariable ordinal regression,
a decreasing eGFR value was associated with an increased CSVD score [Odds Ratio (OR) 0.978,
95% Confidence Interval (CI) 0.962 to 0.995, P=0.013], modified CSVD score 1 (OR 0.973, 95%
CI 0.957 to 0.990, P=0.002) and 2 (OR 0.969, 95% CI 0.953 to 0.986, P<0.001). The link between
eGFR and the total burden of CSVD was significant in strictly deep pICH (P=0.011 for CSVD
score; P=0.001 for modified score 1 and 2), but not strictly lobar pICH in subgroup analysis.
Conclusions: Low eGFR is associated with a high burden of CSVD in patients with deep pICH,
but not lobar pICH. Future studies are warranted to assess whether low eGFR is a potential therapeutic
target for preventing the progress of CSVD burden for deep pICH.