Chronic kidney disease and the severity of coronary artery disease and retinal microvasculature changes: a cross-sectional study.
BACKGROUND
Prior studies have suggested the association between incidence of coronary artery disease (CAD) with chronic kidney disease (CKD) and poor glomerular filtration function. However to the best of our knowledge, few studies have specifically assessed this relationship based on the severity of CAD as quantified using Extent and Gensini scores.


METHODS
Between June 2009 and January 2012, data were collected from 1,680 participants as part of the Australian Heart Eye Study (AHES) cohort. Coronary angiograms were scored according to Gensini (severity) and Extent scores. Retinal vessel calibres were measured using validated semi-automated software. Potential confounders were adjusted for using multivariate analysis.


RESULTS
There were no significant associations found between CKD status with Extent and Gensini scores for CAD severity, both unadjusted and when adjusted for confounding factors. In unadjusted analyses, a significant association between CKD and narrower retinal arteriolar diameter was observed (P=0.0072). After multivariate adjustment, the association between CKD and retinal arteriolar diameter was attenuated and was no longer significant (P=0.1466). No associations were observed between retinal venular calibre and prevalent CKD.


CONCLUSIONS
The present study demonstrated no independent associations between CKD and CAD severity. These results warrant validation by future large, prospective longitudinal studies.
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Kevin
K
Phan
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Cheryl
C
Au
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Paul
P
Mitchell
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Gerald
G
Liew
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Adam J H
AJ
Plant
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Sarah B
SB
Wang
Centre for Heart Research, Westmead Institute, University of Sydney, New South Wales, Australia.
Joseph
J
Chiha
Centre for Heart Research, Westmead Institute, University of Sydney, New South Wales, Australia.
Aravinda
A
Thiagalingam
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
George
G
Burlutsky
Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Bamini
B
Gopinath
Australian Heart Eye Study (AHES); Chronic kidney disease (CKD); coronary artery disease (CAD); cross-sectional study; retinal microvasculature