Retinal microvascular caliber and chronic kidney disease in an Asian population.
Retinal arteriolar narrowing is a marker of microvascular damage from elevated blood pressure. Between August 2004 and June 2006, the authors examined the association between retinal vascular diameter and chronic kidney disease in a population-based cohort of 3,280 community-dwelling adults of Malay ethnicity aged 40-80 years living in Singapore. Chronic kidney disease was defined as 1) an estimated glomerular filtration rate (eGFR) of <60 mL/minute/1.73 m(2) from serum creatinine or 2) the presence of micro/macroalbuminuria defined as urinary albumin:creatinine ratios of > or = 17 mg/g for men and > or = 25 mg/g for women. Retinal arteriolar and venular diameters were measured and summarized as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). Individuals with reduced CRAE were more likely to have chronic kidney disease than those with increased CRAE. After controlling for age, gender, education, smoking, diabetes, hypertension, body mass index, and total and high density lipoprotein cholesterol, the authors found the odds ratio comparing the smallest with the largest CRAE quartile to be 1.42 (95% confidence interval: 1.03, 1.96; P(trend) = 0.02) for eGFR of <60 mL/minute/1.73 m(2) and 1.80 (95% confidence interval: 1.11, 2.91; P(trend) = 0.01) for micro/macroalbuminuria. Retinopathy was also found to be positively associated with both eGFR and micro/macroalbuminuria. Retinal venular diameter was not associated with chronic kidney disease. These data suggest that retinal arteriolar narrowing is associated with chronic kidney disease, independent of diabetes and hypertension.
Sabanayagam
Charumathi
C
Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Shankar
Anoop
A
Koh
David
D
Chia
Kee Seng
KS
Saw
Seang Mei
SM
Lim
Su Chi
SC
Tai
E Shyong
ES
Wong
Tien Yin
TY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007214:Indonesia / Q000208:ethnology; D007674:Kidney Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012161:Retinal Artery / Q000473:pathology* / Q000503:physiopathology; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology