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Abstract
Background: Cerebrovascular diseases are very common in hemodialysis (HD) patients.
Silent cerebral infarction (SCI) has not been investigated in HD patients although
it may be a significant risk factor for cerebrovascular diseases. Hypothesis: Chronic
renal failure may be an independent risk factor for SCI and cerebrovascular diseases.
Methods: Cranial magnetic resonance imaging (MRI) was performed on 123 HD patients
without symptomatic cerebrovascular disease and on 52 control subjects. We investigated
the prevalence of SCI and performed cross-sectional study using multiple logistic
analysis to assess the relationship between SCI and the risk factors. Results: The
prevalence of SCI was significantly higher in HD patients than in the healthy control
group (60 patients (48.8%) vs. 5 patients (9.6%), χ<sup>2</sup> = 22.4, p < 0.0001).
Multiple logistic regression analysis with all subjects showed that independent risk
factors of SCI were chronic renal failure, hypertension, smoking and age (R<sup>2</sup>
= 0.468, p < 0.0001). In only the HD patient group, age and smoking were shown to
be independent risk factors of SCI (R<sup>2</sup> = 0.378, p < 0.0001) while HD duration
and hypertension were not. Conclusions: The findings of the present study indicate
that chronic renal failure maintained by hemodialysis increases the prevalence of
SCI and that age and smoking habits are also significantly associated with SCI in
HD patients.