Bao Shumin, Huang Wen, Liang Yuanbo, Jiang Liping, Wang Fenghua, Peng Yi, Zhang Guangjuan, Wang Ningli
From the Department of Nephrology (SB, WH, LJ, GZ), and Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, and Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China (YL, FW, YP, NW).
Medicine (Baltimore). 2015 Dec;94(49):e2076. doi: 10.1097/MD.0000000000002076.
Few studies have examined the relationship between retinal microvascular abnormalities and chronic kidney disease (CKD). This study aims to examine the association between retinal vessel diameters and CKD in the rural China in order to provide the scientific basis for the early detection and diagnosis for CKD.Participants and data were extracted from the Handan Eye Study, a population-based cross-sectional study performed from 2006 to 2007. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were summarized by the average arteriolar and venular caliber of each eye. The estimated glomerular filtration rate (eGFR) and a urinary albumin to creatinine ratio (ACR) were recorded. Multivariate logistic regression models were used to determine any associations between CRAE, CRVE, arteriole-to-venule ratio (AVR), retinopathy, and CKD in the recruited participants.CKD was found in was 17.3% (892/5158) of this population with a 0.9% (48/5545) rate of reduced renal function and 16.7% (922/5538) rate of albuminuria. Retinopathy was present in 9.6% (571/5925) of participants. Compared to the 4th quartile of AVR, the first group was found to have a higher risk of albuminuria (odds ratio [OR] = 1.261, 95% confidence interval [95%CI]: 1.015-1.567, P = 0.037) and CKD (OR = 1.240, 95%CI: 1.000-1.537, P = 0.049) after adjustment for potential confounding variables. Retinopathy was associated with the occurrence of albuminuria (OR = 1.340, 95%CI: 1.067-1.685, P = 0.012) and CKD (OR = 1.341, 95%CI: 1.071-1.681, P = 0.010). In participants with diabetes, the ORs for the 1st and 4th quartiles of CRAE and CRVE were 2.292 (95%CI: 1.076-4.881, P = 0.032) and 2.113 (95%CI: 1.006-4.438, P = 0.048), respectively. Among the participants with hypertension, retinopathy was also observed to be associated with CKD (OR = 1.306, 95%CI: 1.003-1.699, P = 0.047).The parameters of retinal vessel diameter may be a useful index evaluating the occurrence and development of CKD.
很少有研究探讨视网膜微血管异常与慢性肾脏病（CKD）之间的关系。本研究旨在调查中国农村地区视网膜血管直径与CKD之间的关联，以便为CKD的早期发现和诊断提供科学依据。研究对象和数据来自邯郸眼病研究，这是一项于2006年至2007年开展的基于人群的横断面研究。通过计算每只眼睛的视网膜动脉和静脉平均管径得出视网膜中央动脉等效值（CRAE）和视网膜中央静脉等效值（CRVE）。记录估算肾小球滤过率（eGFR）和尿白蛋白肌酐比值（ACR）。采用多变量逻辑回归模型确定所招募研究对象中CRAE、CRVE、动静脉比（AVR）、视网膜病变与CKD之间的关联。在该人群中，17.3%（892/5158）的人患有CKD，肾功能减退率为0.9%（48/5545），蛋白尿发生率为16.7%（922/5538）。9.6%（571/5925）的研究对象存在视网膜病变。与AVR的第4四分位数相比，在对潜在混杂变量进行校正后，第一组发生蛋白尿（比值比[OR]=1.261，95%置信区间[95%CI]：1.015 - 1.567，P = 0.037）和CKD（OR = 1.240，95%CI：1.000 - 1.537，P = 0.049）的风险更高。视网膜病变与蛋白尿（OR = 1.340，95%CI：1.067 - 1.685，P = 0.012）和CKD（OR = 1.341，95%CI：1.071 - 1.681，P = 0.010）的发生相关。在患有糖尿病的研究对象中，CRAE和CRVE第1四分位数与第4四分位数的OR分别为2.292（95%CI：1.076 - 4.881，P = 0.032）和2.113（95%CI：1.006 - 4.438，P = 0.048）。在患有高血压的研究对象中，视网膜病变也与CKD相关（OR = 1.306，95%CI：1.003 - 1.699，P = 0.047）。视网膜血管直径参数可能是评估CKD发生和发展的有用指标。
