Djordjevic Jocic Jasmina, Cukuranovic Rade, Jovanovic Predrag, Djordjevic Vidosava, Mihajlovic Marija, Bogdanovic Dragan, Cukuranovic-Kokoris Jovana, Stefanovic Vladisav
Clinic of Ophthalmology, Faculty of Medicine, University of Nis, Bul.Zorana Djindjica 81, 18000, Nis, Serbia.
Clinic of Nephrology, Faculty of Medicine, University of Nis, Nis, Serbia.
Int Urol Nephrol. 2015 Oct;47(10):1693-701. doi: 10.1007/s11255-015-1078-x. Epub 2015 Sep 2.
The aim of this study was to examine the ocular fundus pathology in patients with Balkan endemic nephropathy (BN) and chronic kidney diseases (CKD).
The study included 51 patients with BN from the South Morava River region in Serbia, and 102 subjects with different stages of chronic renal diseases, matched according to age and gender, obtained from a database used in a recently published study. All patients had visited Outpatient Department of the Clinic of Nephrology, Clinical Center Nis. All patients underwent routine ophthalmic examinations.
There were significantly more (P < 0.001) patients with age-related macular degeneration (AMD) in the group with BN (31.37 %) than in those with CKD (5.88 %). Multivariate logistic regression analysis confirmed that the significant factors related to AMD in the group with BN were albuminuria (P < 0.05) and proteinuria (P < 0.05); in CKD patients, the level of HDL (P < 0.05), while negative correlation with the level of triglyceride was registered (P < 0.05). There was no association between estimated glomerular filtration rate and AMD. The significant factors related to retinopathy in the group with BN are age (P < 0.05) and serum creatinine values (P < 0.05), in patients with CKD increasing age (P < 0.001) and DM (P < 0.05).
Ocular fundus pathology in patients with BN is similar to the pathology of other CKD, but with significantly more AMD (about four times), probably related to the genetic/epigenetic factors.
本研究旨在检查巴尔干地方性肾病（BN）和慢性肾脏病（CKD）患者的眼底病理情况。
本研究纳入了来自塞尔维亚南摩拉瓦河地区的51例BN患者，以及102例不同阶段慢性肾脏病患者，这些患者根据年龄和性别匹配，数据来源于最近发表的一项研究所使用的数据库。所有患者均就诊于尼斯临床中心肾脏病诊所的门诊。所有患者均接受了常规眼科检查。
BN组中年龄相关性黄斑变性（AMD）患者显著多于CKD组（P<0.001），分别为31.37%和5.88%。多因素逻辑回归分析证实，BN组中与AMD相关的显著因素为蛋白尿（P<0.05）和蛋白尿（P<0.05）；在CKD患者中，HDL水平（P<0.05），而与甘油三酯水平呈负相关（P<0.05）。估计肾小球滤过率与AMD之间无关联。BN组中与视网膜病变相关的显著因素为年龄（P<0.05）和血清肌酐值（P<0.05），在CKD患者中为年龄增加（P<0.001）和糖尿病（P<0.05）。
BN患者的眼底病理与其他CKD的病理相似，但AMD显著更多（约四倍），可能与遗传/表观遗传因素有关。
