Dear madam/ sir, thanks for your question. Ischaemic changes in the brain is quite common after a certain age in most hypertensives (people with high blood pressure). Without a detailed history of your dad s medical problems its not possible to attach significance or dismiss this MRI finding. The fact that he now has kidney faille puts him at high risk of cardiovascular problems like stroke, heart attach etc and he should be on an antiplatelet agent (e.g: Aspirin or clopidogrel) unless there is any contraindication. Other wise he does not need any other treatment for the microvascular disease seen on MRI.Hope this helps. BW