Kislikova Maria, Gaitán-Valdizán Jorge Javier, Parra Blanco José Antonio, García Unzueta María Teresa, Rodríguez Vidriales María, Escagedo Cagigas Clara, Piñera Haces Vicente Celestino, Valentín Muñoz María de la Oliva, Benito Hernández Adalberto, Ruiz San Millan Juan Carlos, Rodrigo Calabia Emilio
Immunopathology Group, Nephrology Department, Marqués de Valdecilla University Hospital-IDIVAL, 39008 Santander, Spain.
Ophthalmology Department, Marqués de Valdecilla University Hospital-IDIVAL, 39008 Santander, Spain.
Life (Basel). 2024 Apr 22;14(4):533. doi: 10.3390/life14040533.
In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart disease, thereby indicating a higher cardiovascular risk profile. Our study aimed to investigate the utility of these techniques in the CKD population. In patients with CKD, OCT was used to measure the choroidal thickness (CHT) and the thickness of the peripapillary retinal nerve fiber layer (pRNFL). A total of 127 patients were included, including 70 men (55%) with an estimated glomerular filtration rate (eGFR) of 39 ± 30 mL/min/1.73 m. Lower pRNFL thickness was found to be related to high-sensitivity troponin I (r = -0.362, < 0.001) and total coronary calcification (r = -0.194, = 0.032). In a multivariate analysis, pRNFL measurements remained associated with age (β = -0.189; -0.739--0.027; = 0.035) and high-sensitivity troponin I (β = -0.301; -0.259--0.071; < 0.001). Severe coronary calcification (Agatston score ≥ 400 HU) was related to a worse eGFR ( = 0.008), a higher grade of CKD ( = 0.036), and a thinner pRNFL ( = 0.011). The ROC curve confirmed that the pRNFL measurement could determine the patients with an Agatston score of ≥400 HU (AUC 0.638; 95% CI 0.525-0.750; = 0.015). Our study concludes that measurement of pRNFL thickness using OCT is related to the markers associated with ischemic heart disease, such as coronary calcification and high-sensitivity troponin I, in the CKD population.
在慢性肾脏病（CKD）患者中，发病和死亡的主要原因是心血管疾病（CVD）。计算机断层扫描（CT）冠状动脉钙化评分和光学相干断层扫描（OCT）均用于识别缺血性心脏病风险增加的患者，从而提示更高的心血管风险状况。我们的研究旨在探讨这些技术在CKD人群中的实用性。在CKD患者中，使用OCT测量脉络膜厚度（CHT）和视乳头周围视网膜神经纤维层（pRNFL）的厚度。共纳入127例患者，其中70例男性（55%），估计肾小球滤过率（eGFR）为39±30 mL/min/1.73 m²。发现较低的pRNFL厚度与高敏肌钙蛋白I相关（r = -0.362，P < 0.001）以及总冠状动脉钙化相关（r = -0.194，P = 0.032）。在多变量分析中，pRNFL测量值仍与年龄相关（β = -0.189；-0.739至-0.027；P = 0.035）和高敏肌钙蛋白I相关（β = -0.301；-0.259至-0.071；P < 0.001）。严重冠状动脉钙化（阿加斯顿评分≥400 HU）与较差的eGFR相关（P = 0.008）、更高等级的CKD相关（P = 0.036）以及更薄的pRNFL相关（P = 0.011）。ROC曲线证实，pRNFL测量可确定阿加斯顿评分≥400 HU的患者（AUC 0.638；95% CI 0.525 - 0.750；P = 0.015）。我们的研究得出结论，在CKD人群中，使用OCT测量pRNFL厚度与缺血性心脏病相关标志物有关，如冠状动脉钙化和高敏肌钙蛋白I。
