title: Retinal microvascular signs are associated with chronic kidney disease in persons with and without diabetes.
abstract: OBJECTIVE
  In persons with diabetes, retinal microvascular abnormalities are associated with chronic kidney disease (CKD). However, it is not clear if the same relationship applies in persons without diabetes.
  
  
  METHODS
  We examined 2,971 participants from a population-based study (240 with, 2,731 without diabetes). Retinal photographs were masked graded for retinal microvascular signs, and CKD was defined as estimated glomerular filtration rate (eGFR(MDRD)) <60 ml/min/1.73 m(2).
  
  
  RESULTS
  Retinal microvascular signs were more frequent in persons with CKD. After adjusting for age, gender, systolic blood pressure and fasting plasma glucose, CKD was associated with both presence of retinopathy (odds ratio, OR, 1.2, 95% confidence interval, CI 1.0-1.5) and venular dilation (OR 1.2, 95% CI 1.0-1.5). These associations were similar in persons with and without diabetes. There was a significant trend for increasing magnitude of associations of retinopathy with increasing severity levels of CKD (p for trend 0.03).
  
  
  CONCLUSIONS
  Retinal microvascular signs, namely retinopathy lesions and venular dilation, are associated with CKD both in persons with, and without diabetes. This supports the concept that retinal microvascular signs are indicators of generalized microvascular disease even in the absence of diabetes, and reinforces the link between retinal and renal microcirculations.
authors.affiliation: Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Liew
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: T Y
authors.initials: TY
authors.lastname: Wong
authors.forename: J J
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011159:Population Surveillance; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology; D012164:Retinal Diseases / Q000175:diagnosis / Q000453:epidemiology