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Retinal structural and vascular alterations in diabetic kidney disease: A bidirectional Mendelian randomization study
Shulei Man1, Kefan Mou1, Yifan Zhang1
1Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Department of Ophthalmology and Research Laboratory of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Microvascular Research
|March 5, 2026
Summary
Diabetic kidney disease (DKD) is linked to changes in retinal thickness and microvasculature. Retinal imaging may help predict DKD risk and progression, suggesting a bidirectional causal relationship between kidney and eye health.
Area of Science:
- Ophthalmology
- Nephrology
- Genetics
Background:
- Diabetic kidney disease (DKD) is associated with retinal structural and microvascular changes.
- The causal relationship between DKD and retinal alterations remains unclear.
Purpose of the Study:
- To investigate the bidirectional causal relationship between DKD and retinal structural and vascular traits using Mendelian randomization (MR).
Main Methods:
- A bidirectional two-sample MR study was conducted using GWAS summary statistics from European populations.
- Eight DKD-related phenotypes were analyzed against retinal layer thickness and microvascular traits.
Main Results:
- Macroalbuminuria was linked to increased inner nuclear layer (INL) thickness.
- CKD-DN was associated with greater choroidal thickness.
- DKD showed negative associations with retinal vascular density (RVD) and retinal vascular fractal dimension (RVFD).
- Increased INL thickness predicted higher risk of end-stage renal disease (ESRD) and extreme chronic kidney disease (CKD).
- Thickening of outer retinal layers was associated with CKD.
Conclusions:
- A potential bidirectional causal link exists between renal dysfunction and retinal neurovascular changes.
- Retinal imaging biomarkers may serve as noninvasive indicators for DKD risk and progression.
