The University of Melbourne, Department of Medicine (Northern Health), The Northern Hospital, Epping VIC 3076, Australia.
Clin J Am Soc Nephrol. 2011 Aug;6(8):1872-8. doi: 10.2215/CJN.10291110. Epub 2011 Jul 22.
Individuals with chronic kidney disease (CKD) stages 3 to 5 have an increased risk of cardiac and other vascular disease. Here we examined the association of CKD 3 to 5 with small vessel caliber.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a cross-sectional observational study of 126 patients with CKD stages 3 to 5 (estimated GFR [eGFR] <60 ml/min per 1.73 m(2)) and 126 age- and gender-matched hospital patients with CKD 1 or 2. Retinal vessel diameters were measured from digital fundus images by a trained grader using a computer-assisted method and summarized as the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE).
Patients with CKD 3 to 5 had a smaller mean CRAE and CRVE than hospital controls (139.4 ± 17.8 μm versus 148.5 ± 16.0 μm, P < 0.001; and 205.0 ± 30.7 μm versus 217.4 ± 25.8 μm, respectively; P = 0.001). CRAE and CRVE decreased progressively with each stage of renal failure CKD1-2 to 5 (P for trend = 0.08 and 0.04, respectively). CKD and hypertension were independent determinants of arteriolar narrowing after adjusting for age, gender, diabetes, dyslipidemia, and smoking history. Patients with CKD 5 and diabetes had a larger mean CRAE and CRVE than nondiabetics (141.4 ± 14.9 μm versus 132.9 ± 14.2 μm; 211.1 ± 34.4 μm versus 194.8 ± 23.8 μm).
The microvasculature is narrowed in patients with reduced eGFR.
患有慢性肾脏病（CKD）3 至 5 期的个体患心脏和其他血管疾病的风险增加。在此，我们研究了 CKD 3 至 5 期与小血管口径的相关性。
设计、设置、参与者和测量：这是一项横断面观察性研究，纳入了 126 名 CKD 3 至 5 期（估算肾小球滤过率[eGFR]＜60ml/min/1.73m2）患者和 126 名年龄和性别匹配的 CKD 1 或 2 期住院患者。通过受过培训的分级员使用计算机辅助方法从数字眼底图像中测量视网膜血管直径，并将其总结为中央视网膜动脉等效直径（CRAE）和中央视网膜静脉等效直径（CRVE）。
与住院对照组相比，CKD 3 至 5 期患者的平均 CRAE 和 CRVE 较小（139.4±17.8μm比 148.5±16.0μm，P＜0.001；205.0±30.7μm比 217.4±25.8μm，P=0.001）。随着肾功能衰竭 CKD1-2 至 5 期的进展，CRAE 和 CRVE 逐渐降低（趋势 P 值分别为 0.08 和 0.04）。在调整年龄、性别、糖尿病、血脂异常和吸烟史后，CKD 和高血压是小动脉狭窄的独立决定因素。与非糖尿病患者相比，CKD 5 期合并糖尿病患者的平均 CRAE 和 CRVE 更大（141.4±14.9μm比 132.9±14.2μm；211.1±34.4μm比 194.8±23.8μm）。
eGFR 降低的患者微血管狭窄。
