Chronic kidney disease defined by 24-hour urinary albumin and silent brain infarction in community-dwelling older adults

Chronic kidney disease defined by 24-hour urinary albumin and silent brain infarction in community-dwelling older adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Chronic kidney disease defined by 24-hour urinary albumin and silent brain infarction in community-dwelling older adults Kenji Fukuda, Hiroshi Yao, Masahiro Kamouchi, Toru Nabika, Mari Mori, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7191689/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Albuminuria is a well-established marker of chronic kidney disease (CKD) and a known risk factor for stroke. However, its relationship with silent brain infarction (SBI), a key imaging marker of cerebral small vessel disease (CSVD), remains unclear. Importantly, no prior study has examined this association using quantitative 24-h urine collection. We conducted a cross-sectional study of 296 community-dwelling older adults (mean age: 68.7 years) who underwent brain magnetic resonance imaging (MRI) and comprehensive health screening, including 24-h urine sampling. SBI was identified in 26 participants (8.8%), and albuminuria (≥ 30 mg/day) in 30 (10.1%). In multivariable logistic regression (Model 1), age and hypertension were significantly associated with SBI, while estimated glomerular filtration rate was not. In Model 2, which included urinary indices, log-transformed 24-h urinary albumin was independently associated with SBI (odds ratio [OR]: 3.30; 95% confidence intervals [CI]: 1.38–7.87), and the association with hypertension lost significance. Sensitivity analyses excluding three macroalbuminuria cases produced similar results. Moderately increased albuminuria (30–299 mg/day), measured via 24-h urine collection, may serve as an early indicator of SBI due to CSVD, even in individuals with preserved renal function. Health sciences/Biomarkers Health sciences/Diseases Health sciences/Medical research Health sciences/Nephrology Health sciences/Neurology silent brain infarction albuminuria 24-hour urine collection cerebral small vessel disease community-based study Full Text Additional Declarations No competing interests reported. Supplementary Files SBI24hAlbuminSupplementary.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 06 Apr, 2026 Reviewers invited by journal 06 Apr, 2026 Editor assigned by journal 26 Nov, 2025 Editor invited by journal 07 Aug, 2025 Submission checks completed at journal 26 Jul, 2025 First submitted to journal 26 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7191689","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":620355834,"identity":"60462bb6-c02a-402b-bb02-99abe9b25774","order_by":0,"name":"Kenji Fukuda","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYBACCeYDzAwMBjZy8uwNQK6BBRFa2BKAWirSjA17DoC0SBCr5czhxIYbCWA+YS2SbTzGxrxthxkbZz6/uuFHgQQDf3t3Al4t0mw8xsm8benM7NI5ZTd7gA6TOHN2A14tcvI9xod526zZGGfnpN3gAWoxkMgloAVoC1ALMw/DzTNpN/8QowXsMJ4zzhIMN9iP3SbKFsk2tmLDORVpBoY9OWy3ZQwkeAj6ReIY82aJNwY29fPZjz+7+eaPjRx/ey9+LUiAxwBMEqscBNgfkKJ6FIyCUTAKRhAAAFidQadMz0TWAAAAAElFTkSuQmCC","orcid":"","institution":"St. Mary’s Research Center","correspondingAuthor":true,"prefix":"","firstName":"Kenji","middleName":"","lastName":"Fukuda","suffix":""},{"id":620355835,"identity":"45819264-f2c5-4100-8d43-2a00e54590d1","order_by":1,"name":"Hiroshi Yao","email":"","orcid":"","institution":"St. Mary’s Research Center","correspondingAuthor":false,"prefix":"","firstName":"Hiroshi","middleName":"","lastName":"Yao","suffix":""},{"id":620355836,"identity":"bc01c702-b963-44b0-8235-c77510139eb4","order_by":2,"name":"Masahiro Kamouchi","email":"","orcid":"","institution":"Kyushu University","correspondingAuthor":false,"prefix":"","firstName":"Masahiro","middleName":"","lastName":"Kamouchi","suffix":""},{"id":620355837,"identity":"10062458-83c5-4ef5-984e-64d9a7f4331f","order_by":3,"name":"Toru Nabika","email":"","orcid":"","institution":"Shimane University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Toru","middleName":"","lastName":"Nabika","suffix":""},{"id":620355838,"identity":"ef77be9e-2d6a-4197-8e76-f595b76dc4dc","order_by":4,"name":"Mari Mori","email":"","orcid":"","institution":"The Jikei University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Mari","middleName":"","lastName":"Mori","suffix":""},{"id":620355839,"identity":"f1c5e4a0-55e5-4160-9c8b-20000707667e","order_by":5,"name":"Hideki Mori","email":"","orcid":"","institution":"Mukogawa Women's University Research Institute for Health Science","correspondingAuthor":false,"prefix":"","firstName":"Hideki","middleName":"","lastName":"Mori","suffix":""},{"id":620355840,"identity":"c9c690bc-6a9d-4d51-8930-78a7a648b333","order_by":6,"name":"Yasushi Okada","email":"","orcid":"","institution":"St. Mary’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yasushi","middleName":"","lastName":"Okada","suffix":""},{"id":620355841,"identity":"1708f5be-eabc-4459-be6d-bd33ec0eafad","order_by":7,"name":"Tetsuro Ago","email":"","orcid":"","institution":"Kyushu University","correspondingAuthor":false,"prefix":"","firstName":"Tetsuro","middleName":"","lastName":"Ago","suffix":""},{"id":620355842,"identity":"26b8a4ae-e9eb-41c4-8833-40632c45f11e","order_by":8,"name":"Yukio Yamori","email":"","orcid":"","institution":"Mukogawa Women's University Research Institute for Health Science","correspondingAuthor":false,"prefix":"","firstName":"Yukio","middleName":"","lastName":"Yamori","suffix":""}],"badges":[],"createdAt":"2025-07-23 03:38:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7191689/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7191689/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106993570,"identity":"6d5ee901-e143-4541-95ef-77a1a2b23f9d","added_by":"auto","created_at":"2026-04-15 14:37:55","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":380562,"visible":true,"origin":"","legend":"","description":"","filename":"RevisedManuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7191689/v1_covered_ab3b82f6-0015-4f38-a109-bb4bde1be18a.pdf"},{"id":106635319,"identity":"34bbd21e-c537-4db9-a3e6-495653a8a053","added_by":"auto","created_at":"2026-04-10 16:44:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":1143752,"visible":true,"origin":"","legend":"","description":"","filename":"SBI24hAlbuminSupplementary.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7191689/v1/8ae9127e6bb8f914ca749507.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Chronic kidney disease defined by 24-hour urinary albumin and silent brain infarction in community-dwelling older adults","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"silent brain infarction, albuminuria, 24-hour urine collection, cerebral small vessel disease, community-based study","lastPublishedDoi":"10.21203/rs.3.rs-7191689/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7191689/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Albuminuria is a well-established marker of chronic kidney disease (CKD) and a known risk factor for stroke. However, its relationship with silent brain infarction (SBI), a key imaging marker of cerebral small vessel disease (CSVD), remains unclear. Importantly, no prior study has examined this association using quantitative 24-h urine collection. We conducted a cross-sectional study of 296 community-dwelling older adults (mean age: 68.7 years) who underwent brain magnetic resonance imaging (MRI) and comprehensive health screening, including 24-h urine sampling. SBI was identified in 26 participants (8.8%), and albuminuria (≥ 30 mg/day) in 30 (10.1%). In multivariable logistic regression (Model 1), age and hypertension were significantly associated with SBI, while estimated glomerular filtration rate was not. In Model 2, which included urinary indices, log-transformed 24-h urinary albumin was independently associated with SBI (odds ratio [OR]: 3.30; 95% confidence intervals [CI]: 1.38–7.87), and the association with hypertension lost significance. Sensitivity analyses excluding three macroalbuminuria cases produced similar results. Moderately increased albuminuria (30–299 mg/day), measured via 24-h urine collection, may serve as an early indicator of SBI due to CSVD, even in individuals with preserved renal function.","manuscriptTitle":"Chronic kidney disease defined by 24-hour urinary albumin and silent brain infarction in community-dwelling older adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-10 16:44:13","doi":"10.21203/rs.3.rs-7191689/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"259948202598306482187267464393607649620","date":"2026-04-06T12:23:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-06T09:49:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-26T07:33:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-07T04:13:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-26T04:58:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-07-26T04:55:21+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1871ca80-bbe9-4d61-8d9d-57c349fd4aa1","owner":[],"postedDate":"April 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":66019274,"name":"Health sciences/Biomarkers"},{"id":66019275,"name":"Health sciences/Diseases"},{"id":66019276,"name":"Health sciences/Medical research"},{"id":66019277,"name":"Health sciences/Nephrology"},{"id":66019278,"name":"Health sciences/Neurology"}],"tags":[],"updatedAt":"2026-04-10T16:44:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-10 16:44:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7191689","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7191689","identity":"rs-7191689","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}