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Chronic kidney disease and the severity of coronary artery disease and retinal microvasculature changes: a
Kevin Phan1, Cheryl Au1, Paul Mitchell1
1Centre for Vision Research, Department of Ophthalmology and Westmead Institute, University of Sydney, Sydney, New South Wales, Australia ;
Insights
This study found no link between chronic kidney disease (CKD) and coronary artery disease (CAD) severity. Further research is needed to confirm these findings on CAD and CKD.
Area of Science:
- Cardiology
- Nephrology
- Ophthalmology
Background:
- Prior research suggests a link between coronary artery disease (CAD) and chronic kidney disease (CKD).
- Few studies have investigated this relationship based on CAD severity using Extent and Gensini scores.
Purpose of the Study:
- To assess the association between chronic kidney disease (CKD) and coronary artery disease (CAD) severity.
- To evaluate the relationship using Gensini and Extent scores in the Australian Heart Eye Study (AHES) cohort.
Main Methods:
- Data from 1,680 participants in the Australian Heart Eye Study (AHES) cohort (June 2009-January 2012).
- Coronary angiograms scored using Gensini (severity) and Extent scores.
- Retinal vessel calibres measured; multivariate analysis adjusted for confounders.
Main Results:
- No significant associations were found between CKD status and CAD severity (Extent/Gensini scores).
- An initial association between CKD and narrower retinal arteriolar diameter was not significant after multivariate adjustment.
- No associations observed between CKD and retinal venular calibre.
Conclusions:
- No independent associations were found between chronic kidney disease (CKD) and coronary artery disease (CAD) severity.
- Results suggest that CKD may not be independently associated with CAD severity.
- Further large, prospective longitudinal studies are warranted to validate these findings.
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.
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