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Retinal Vessel Diameter and Chronic Kidney Disease in Rural China: A Cross-Sectional Study
Shumin Bao1, Wen Huang, Yuanbo Liang
1From the Department of Nephrology (SB, WH, LJ, GZ), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, and Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China (YL, FW, YP, NW).
Insights
Retinal microvascular changes, including retinopathy and altered arteriole-to-venule ratio, are linked to chronic kidney disease (CKD) risk in rural Chinese adults. These findings suggest retinal vessel diameter may aid in early CKD detection.
Area of Science:
- Ophthalmology
- Nephrology
- Public Health
Background:
- Limited research exists on the connection between retinal microvascular abnormalities and chronic kidney disease (CKD).
- Understanding this relationship is crucial for developing early detection strategies for CKD.
Purpose of the Study:
- To investigate the association between retinal vessel diameters and CKD in a rural Chinese population.
- To establish a scientific basis for early CKD detection and diagnosis using retinal imaging.
Main Methods:
- Utilized data from the Handan Eye Study, a population-based cross-sectional study.
- Measured central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriole-to-venule ratio (AVR).
- Assessed CKD using estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR), employing multivariate logistic regression.
Main Results:
- CKD prevalence was 17.3%, with reduced renal function at 0.9% and albuminuria at 16.7%.
- Lower AVR (first quartile) correlated with increased risk of albuminuria and CKD.
- Retinopathy was significantly associated with albuminuria and CKD, particularly in participants with hypertension and diabetes.
Conclusions:
- Retinal vessel diameter parameters, including AVR and retinopathy, show potential as indicators for evaluating CKD occurrence and progression.
- These findings support the use of retinal examinations for early CKD screening, especially in at-risk populations.
Abstract:
Few studies have examined the relationship between retinal microvascular abnormalities and chronic kidney disease (CKD). This study aims to examine the association between retinal vessel diameters and CKD in the rural China in order to provide the scientific basis for the early detection and diagnosis for CKD.Participants and data were extracted from the Handan Eye Study, a population-based cross-sectional study performed from 2006 to 2007. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were summarized by the average arteriolar and venular caliber of each eye. The estimated glomerular filtration rate (eGFR) and a urinary albumin to creatinine ratio (ACR) were recorded. Multivariate logistic regression models were used to determine any associations between CRAE, CRVE, arteriole-to-venule ratio (AVR), retinopathy, and CKD in the recruited participants.CKD was found in was 17.3% (892/5158) of this population with a 0.9% (48/5545) rate of reduced renal function and 16.7% (922/5538) rate of albuminuria. Retinopathy was present in 9.6% (571/5925) of participants. Compared to the 4th quartile of AVR, the first group was found to have a higher risk of albuminuria (odds ratio [OR] = 1.261, 95% confidence interval [95%CI]: 1.015-1.567, P = 0.037) and CKD (OR = 1.240, 95%CI: 1.000-1.537, P = 0.049) after adjustment for potential confounding variables. Retinopathy was associated with the occurrence of albuminuria (OR = 1.340, 95%CI: 1.067-1.685, P = 0.012) and CKD (OR = 1.341, 95%CI: 1.071-1.681, P = 0.010). In participants with diabetes, the ORs for the 1st and 4th quartiles of CRAE and CRVE were 2.292 (95%CI: 1.076-4.881, P = 0.032) and 2.113 (95%CI: 1.006-4.438, P = 0.048), respectively. Among the participants with hypertension, retinopathy was also observed to be associated with CKD (OR = 1.306, 95%CI: 1.003-1.699, P = 0.047).The parameters of retinal vessel diameter may be a useful index evaluating the occurrence and development of CKD.
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