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Updated: Jun 27, 2025
Assessment of Kidney Function in Mouse Models of Glomerular Disease
Published on: June 30, 2018
Looking into the Eyes to See the Heart of Chronic Kidney Disease Patients
Maria Kislikova1, Jorge Javier Gaitán-Valdizán2, José Antonio Parra Blanco3
1Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital-IDIVAL, 39008 Santander, Spain.
Insights
Optical coherence tomography (OCT) can assess peripapillary retinal nerve fiber layer (pRNFL) thickness in chronic kidney disease (CKD) patients. Thinner pRNFL is linked to higher cardiovascular disease risk markers like coronary calcification and troponin I.
Area of Science:
- Ophthalmology
- Nephrology
- Cardiology
Background:
- Cardiovascular disease (CVD) is a primary cause of mortality in chronic kidney disease (CKD) patients.
- Coronary artery calcium scoring and optical coherence tomography (OCT) identify individuals at high risk for ischemic heart disease.
- The utility of these techniques in the CKD population requires further investigation.
Purpose of the Study:
- To investigate the role of OCT-measured peripapillary retinal nerve fiber layer (pRNFL) thickness in assessing cardiovascular risk in CKD patients.
- To correlate pRNFL thickness with established markers of ischemic heart disease, including coronary calcification and high-sensitivity troponin I.
Main Methods:
- 127 CKD patients underwent OCT to measure choroidal thickness (CHT) and pRNFL thickness.
- Coronary artery calcification was assessed using computed tomography (CT) calcium scoring.
- Statistical analyses, including multivariate analysis and ROC curve analysis, were performed.
Main Results:
- Lower pRNFL thickness correlated with higher high-sensitivity troponin I levels and total coronary calcification.
- Multivariate analysis showed pRNFL thickness associated with age and high-sensitivity troponin I.
- Severe coronary calcification (Agatston score ≥ 400 HU) was linked to worse estimated glomerular filtration rate (eGFR), higher CKD grade, and thinner pRNFL.
Conclusions:
- OCT-measured pRNFL thickness is associated with markers of ischemic heart disease in CKD patients.
- pRNFL thickness may serve as a potential indicator for cardiovascular risk stratification in this population.
- Further research is warranted to explore the clinical implications of these findings.
Abstract:
In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart disease, thereby indicating a higher cardiovascular risk profile. Our study aimed to investigate the utility of these techniques in the CKD population. In patients with CKD, OCT was used to measure the choroidal thickness (CHT) and the thickness of the peripapillary retinal nerve fiber layer (pRNFL). A total of 127 patients were included, including 70 men (55%) with an estimated glomerular filtration rate (eGFR) of 39 ± 30 mL/min/1.73 m2. Lower pRNFL thickness was found to be related to high-sensitivity troponin I (r = -0.362, p < 0.001) and total coronary calcification (r = -0.194, p = 0.032). In a multivariate analysis, pRNFL measurements remained associated with age (β = -0.189; -0.739--0.027; p = 0.035) and high-sensitivity troponin I (β = -0.301; -0.259--0.071; p < 0.001). Severe coronary calcification (Agatston score ≥ 400 HU) was related to a worse eGFR (p = 0.008), a higher grade of CKD (p = 0.036), and a thinner pRNFL (p = 0.011). The ROC curve confirmed that the pRNFL measurement could determine the patients with an Agatston score of ≥400 HU (AUC 0.638; 95% CI 0.525-0.750; p = 0.015). Our study concludes that measurement of pRNFL thickness using OCT is related to the markers associated with ischemic heart disease, such as coronary calcification and high-sensitivity troponin I, in the CKD population.
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