Microvascular changes at different stages of chronic kidney disease
Kannenkeril D, Frost S, Nolde JM, Kiuchi MG, Carnagarin R, Lugo-Gavidia LM, Chan J, Joyson A, Matthews VB, Herat LY, Azzam O, Mehdizadeh M, Vignarajan J, Kanagasingam Y, Schlaich MP (2020)
Publication Type: Journal article
Publication year: 2020
Journal
DOI: 10.1111/jch.14138
Abstract
Patients with progressing chronic kidney disease (CKD) are more likely to experience cardio- and cerebrovascular events than progressing to end-stage renal disease. The authors explored whether retinal microvascular calibers differed with the degree of renal impairment and between the standard and extended optic disk and may serve as a simple additional tool for risk stratification in this highly vulnerable patient cohort. The authors analyzed central retinal arteriolar and venular equivalent calibers (CRAE, CRVE) at different retinal zones (zone B&C) using digital retinal imaging in hypertensive patients with stage 2 (n = 66) or stage 3 CKD (n = 30). Results were adjusted for age, sex, HbA1c, and 24-hour diastolic blood pressure. Mean eGFR was 77.7 ± 8.9 and 48.8 ± 7.9 ml/min/1.73 m2 for stage 2 and 3 CKD, respectively. CRAE and CRVE in zones B and C were significantly lower in patients with stage 3 CKD compared to patients with stage 2 CKD (CRAE-B:141.1 ± 21.4 vs. 130.5 ± 18.9 µm, p =.030; CRAE-C:137.4 ± 19.4 vs 129.2 ± 18.2 µm, p =.049; CRVE-B:220.8 ± 33.0 vs. 206.0 ± 28.4 µm, p =.004; and CRVE-C:215.9 ± 33.0 vs. 201.2 ± 25.1µm, p =.003). In patients with stage 2 CKD, CRAE-B was higher than CRAE-C (141.1 ± 21.4 vs. 137.4 ± 19.4µm, p <.001). In contrast, such a difference was not found in patients with stage 3 CKD. CRAE of both retinal zones correlated with eGFR for the entire cohort. In patients with stage 3 CKD, retinal narrowing is more pronounced compared to patients with stage 2 CKD. Whether the novel observation of difference in arteriolar caliber between zones B and C in stage 2 CKD could serve as an early marker of CKD progression warrants further investigation.
Involved external institutions
University of Western Australia (UWA)
Australia (AU)
Commonwealth Scientific and Industrial Research Organisation (CSIRO)
Australia (AU)
Australia (AU)
Commonwealth Scientific and Industrial Research Organisation (CSIRO)
Australia (AU)
How to cite
APA:
Kannenkeril, D., Frost, S., Nolde, J.M., Kiuchi, M.G., Carnagarin, R., Lugo-Gavidia, L.M.,... Schlaich, M.P. (2020). Microvascular changes at different stages of chronic kidney disease. Journal of Clinical Hypertension. https://doi.org/10.1111/jch.14138
MLA:
Kannenkeril, Dennis, et al. "Microvascular changes at different stages of chronic kidney disease." Journal of Clinical Hypertension (2020).
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