title: The microvasculature in chronic kidney disease.
abstract: OBJECTIVE
  Individuals with chronic kidney disease (CKD) stages 3 to 5 have an increased risk of cardiac and other vascular disease. Here we examined the association of CKD 3 to 5 with small vessel caliber.
  
  
  METHODS
  This was a cross-sectional observational study of 126 patients with CKD stages 3 to 5 (estimated GFR [eGFR] <60 ml/min per 1.73 m(2)) and 126 age- and gender-matched hospital patients with CKD 1 or 2. Retinal vessel diameters were measured from digital fundus images by a trained grader using a computer-assisted method and summarized as the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE).
  
  
  RESULTS
  Patients with CKD 3 to 5 had a smaller mean CRAE and CRVE than hospital controls (139.4 ± 17.8 μm versus 148.5 ± 16.0 μm, P < 0.001; and 205.0 ± 30.7 μm versus 217.4 ± 25.8 μm, respectively; P = 0.001). CRAE and CRVE decreased progressively with each stage of renal failure CKD1-2 to 5 (P for trend = 0.08 and 0.04, respectively). CKD and hypertension were independent determinants of arteriolar narrowing after adjusting for age, gender, diabetes, dyslipidemia, and smoking history. Patients with CKD 5 and diabetes had a larger mean CRAE and CRVE than nondiabetics (141.4 ± 14.9 μm versus 132.9 ± 14.2 μm; 211.1 ± 34.4 μm versus 194.8 ± 23.8 μm).
  
  
  CONCLUSIONS
  The microvasculature is narrowed in patients with reduced eGFR.
authors.affiliation: The University of Melbourne, Department of Medicine (Northern Health), The Northern Hospital, Epping VIC 3076, Australia.
authors.forename: Qi Lun
authors.initials: QL
authors.lastname: Ooi
authors.forename: Foong Kien Newk-Fon Hey
authors.initials: FK
authors.lastname: Tow
authors.forename: Raj
authors.initials: R
authors.lastname: Deva
authors.forename: Mohamad Afzal
authors.initials: MA
authors.lastname: Alias
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawasaki
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: Nor
authors.initials: N
authors.lastname: Mohamad
authors.forename: Deb
authors.initials: D
authors.lastname: Colville
authors.forename: Anastasia
authors.initials: A
authors.lastname: Hutchinson
authors.forename: Judy
authors.initials: J
authors.lastname: Savige
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001160:Arterioles / Q000473:pathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012161:Retinal Artery / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D012169:Retinal Vein / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D014699:Venules / Q000473:pathology; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult