Retinal microvascular abnormalities and renal dysfunction: the atherosclerosis risk in communities study.

Kleins Lab // Publications // Sep 01 2004

PubMed ID: 15339997

Author(s): Wong TY, Coresh J, Klein R, Muntner P, Couper DJ, Sharrett AR, Klein BE, Heiss G, Hubbard LD, Duncan BB. Retinal microvascular abnormalities and renal dysfunction: the Atherosclerosis Risk in Communities Study. J Am Soc Nephrol. 2004 Sep;15(9):2469-76. PMID 15339997

Journal: Journal Of The American Society Of Nephrology : Jasn, Volume 15, Issue 9, Sep 2004

Microvascular disease has been linked with renal dysfunction in patients with diabetes. The aim of this study was to examine the association of retinal microvascular abnormalities to renal dysfunction among participants of the Atherosclerosis Risk in Communities Study, a population-based investigation in four U.S. communities. At the third examination (1993 to 1995), retinal photography was performed and the presence of retinal microvascular abnormalities was documented using a standard grading protocol. Renal dysfunction was defined as an increase in serum creatinine of at least 0.4 mg/dl or a death or hospitalization as a result of chronic kidney disease between the second (1990 to 1992) and fourth (1996 to 1998) examinations. Among 10,056 people who were included in the study, 270 (2.7%) developed renal dysfunction. After controlling for age, gender, race, diabetes, BP, and other risk factors, individuals with retinopathy (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.4 to 2.8), microaneurysms (OR, 2.0; 95% CI, 1.3 to 3.1), retinal hemorrhages (OR, 2.6; 95% CI, 1.6 to 4.0), soft exudates (OR, 2.7; 95% CI, 1.6 to 4.8), and arteriovenous nicking (OR, 1.4; 95% CI, 1.0 to 1.9) were more likely to develop renal dysfunction than individuals without these abnormalities. Retinal microvascular abnormalities are associated with renal dysfunction, suggesting that common systemic microvascular processes may underlie the development of microvascular damage in the eye and kidneys.