Retinal arteriolar narrowing is a marker of microvascular damage from elevated blood pressure. Between August 2004 and June 2006, the authors examined the association between
retinal vascular diameter and
chronic kidney disease in a population-based cohort of 3,280 community-dwelling adults of Malay ethnicity aged 40-80 years living in Singapore.
Chronic kidney disease was defined as 1) an estimated glomerular filtration rate (eGFR) of <60 mL/minute/1.73 m(2) from serum
creatinine or 2) the presence of micro/macroalbuminuria defined as urinary
albumin:
creatinine ratios of > or = 17 mg/g for men and > or = 25 mg/g for women.
Retinal arteriolar and venular diameters were measured and summarized as central
retinal arteriolar equivalent (CRAE) and central
retinal venular equivalent (CRVE). Individuals with reduced CRAE were more likely to have
chronic kidney disease than those with increased CRAE. After controlling for age, gender, education, smoking, diabetes,
hypertension, body mass index, and total and
high density lipoprotein cholesterol, the authors found the odds ratio comparing the smallest with the largest CRAE quartile to be 1.42 (95% confidence interval: 1.03, 1.96; P(trend) = 0.02) for eGFR of <60 mL/minute/1.73 m(2) and 1.80 (95% confidence interval: 1.11, 2.91; P(trend) = 0.01) for micro/macroalbuminuria. Retinopathy was also found to be positively associated with both eGFR and micro/macroalbuminuria.
Retinal venular diameter was not associated with
chronic kidney disease. These data suggest that
retinal arteriolar narrowing is associated with
chronic kidney disease, independent of diabetes and
hypertension.