Yasin ÖZTÜRK, Cemile Feyza ELBİSTAN, Merve ORUÇ, Mehmet Burak ERÇİN, Hakan ÖZER, Fethi YÖNET, Hasan Hüseyin KOZAK, Ganime Dilek EMLİK, İsmail BALOĞLU, Nedim Yılmaz SELÇUK, Halil Zeki TONBUL, Kültigin TÜRKMEN
Turkish Journal of Internal Medicine - 2026;8(1):165-172
Objective: Silent brain lesions (SBL), including silent brain infarction (SBI) and subcortical white matter lesions (SWML), are increasingly recognized as important radiological markers of cerebral small vessel disease. Patients with chronic kidney disease (CKD) may be at increased risk due to shared vascular and metabolic abnormalities. This study aimed to investigate the prevalence, radiological characteristics, and predictors of SBL in patients with CKD. Methods: This retrospective study included 276 patients with CKD who underwent brain magnetic resonance imaging (MRI) between March 2020 and March 2021. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m², and patients undergoing hemodialysis were included. MRI findings were classified as SBI, SWML, overt stroke, or no lesion. Silent brain lesions were defined as the presence of SBI and/or SWML in patients without a clinical history of stroke or focal neurological deficits. Clinical and laboratory data were analyzed, and independent predictors were determined using binary logistic regression. Results: Pathological MRI findings were detected in 177 patients (64.1%). Among them, 131 patients (74.0%) had SBL (73 SWML and 58 SBI), while 46 (26.0%) had overt stroke. Patients with SBL were older and had a higher prevalence of diabetes mellitus and hypertension compared with those with overt stroke. In multivariate logistic regression analysis, older age (OR: 1.073, 95% CI: 1.051-1.096; p < 0.001) and higher serum creatinine levels (OR: 1.306, 95% CI: 1.096-1.557; p = 0.003) were identified as independent predictors of SBL. Among patients with SBL, those with SWML had a longer duration of hemodialysis compared to those with SBI. Conclusion: Silent brain lesions are highly prevalent in patients with CKD. Older age and impaired renal function are independent predictors of SBL. These findings highlight the importance of cerebrovascular risk assessment in CKD patients, particularly in older individuals and those with advanced renal dysfunction.
