TY - JOUR
T1 - Retinal arteriolar narrowing and subsequent development of CKD stage 3
T2 - The multi-ethnic study of atherosclerosis (MESA)
AU - Yau, Joanne Wen Yee
AU - Xie, Jing
AU - Kawasaki, Ryo
AU - Kramer, Holly
AU - Shlipak, Michael
AU - Klein, Ronald
AU - Klein, Barbara
AU - Cotch, Mary Frances
AU - Wong, Tien Yin
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Background: Microvascular disease is a major pathogenic factor for chronic kidney disease (CKD) in persons with diabetes, but the role of microvascular disease in the development of CKD in the general population is unclear. The aim of this study is to examine whether microvascular disease precedes the development of CKD stage 3 in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Study Design: Population-based cohort study. Setting & Participants: MESA is a prospective cohort study of adults aged 45-84 years living in 6 US communities; 4,594 adults with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 when they underwent retinal photography (visit 2: in 2002-2004) were examined. Predictor: Retinal microvascular caliber measured from fundus photographs. Outcomes: Incident CKD stage 3 (ie, eGFR <60 mL/min/1.73 m2) at 2 subsequent follow-up examinations (visit 3 in 2004-2005, and visit 4 in 2005-2007) and an annual eGFR decrease >1 mL/min/1.73 m2 computed using the CKD Epidemiology Collaboration (CKD-EPI) equation. Results: After a median follow-up of 4.8 years, there were 232 incident CKD stage 3 cases. Overall, retinal microvascular caliber was not associated with incident CKD stage 3. However, in race-stratified analysis, narrower arterioles in whites was associated with a higher risk of developing CKD stage 3 after adjusting for age, sex, blood pressure, diabetes, and other factors (HR, 1.78; 95% CI, 1.01-3.15; P = 0.04, lowest vs highest arteriolar caliber tertile). This association was seen even in whites without hypertension and diabetes (HR, 2.95; 95% CI, 1.10-7.98; P = 0.03). Retinal arteriolar caliber was not associated with incident CKD stage 3 in African Americans, Chinese, or Hispanics. Limitations: Analyses were based on a single eGFR measurement, and retinal microvascular caliber and eGFR measurements were not ascertained concurrently. Conclusion: Microvascular changes as manifest in the eye may contribute to the development of CKD stage 3 in whites.
AB - Background: Microvascular disease is a major pathogenic factor for chronic kidney disease (CKD) in persons with diabetes, but the role of microvascular disease in the development of CKD in the general population is unclear. The aim of this study is to examine whether microvascular disease precedes the development of CKD stage 3 in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Study Design: Population-based cohort study. Setting & Participants: MESA is a prospective cohort study of adults aged 45-84 years living in 6 US communities; 4,594 adults with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 when they underwent retinal photography (visit 2: in 2002-2004) were examined. Predictor: Retinal microvascular caliber measured from fundus photographs. Outcomes: Incident CKD stage 3 (ie, eGFR <60 mL/min/1.73 m2) at 2 subsequent follow-up examinations (visit 3 in 2004-2005, and visit 4 in 2005-2007) and an annual eGFR decrease >1 mL/min/1.73 m2 computed using the CKD Epidemiology Collaboration (CKD-EPI) equation. Results: After a median follow-up of 4.8 years, there were 232 incident CKD stage 3 cases. Overall, retinal microvascular caliber was not associated with incident CKD stage 3. However, in race-stratified analysis, narrower arterioles in whites was associated with a higher risk of developing CKD stage 3 after adjusting for age, sex, blood pressure, diabetes, and other factors (HR, 1.78; 95% CI, 1.01-3.15; P = 0.04, lowest vs highest arteriolar caliber tertile). This association was seen even in whites without hypertension and diabetes (HR, 2.95; 95% CI, 1.10-7.98; P = 0.03). Retinal arteriolar caliber was not associated with incident CKD stage 3 in African Americans, Chinese, or Hispanics. Limitations: Analyses were based on a single eGFR measurement, and retinal microvascular caliber and eGFR measurements were not ascertained concurrently. Conclusion: Microvascular changes as manifest in the eye may contribute to the development of CKD stage 3 in whites.
KW - chronic kidney disease
KW - Microvascular changes
KW - retinal microvascular caliber
UR - http://www.scopus.com/inward/record.url?scp=79959328757&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2011.02.382
DO - 10.1053/j.ajkd.2011.02.382
M3 - Article
C2 - 21549464
AN - SCOPUS:79959328757
SN - 0272-6386
VL - 58
SP - 39
EP - 46
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 1
ER -
