Carollo Caterina, Vadalà Maria, Sorce Alessandra, Cirafici Emanuele, Bennici Miriam, Castellucci Massimo, Bonfiglio Vincenza Maria Elena, Mulè Giuseppe, Geraci Giulio
Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy.
Biomedicine, Neuroscience and Advance Diagnostic (BIND) Department, University of Palermo, 90133 Palermo, Italy.
Biomedicines. 2025 May 12;13(5):1176. doi: 10.3390/biomedicines13051176.
The eye and kidney share embryological, structural, and pathophysiological similarities, suggesting potential interconnections between retinal and renal microvascular changes. Hypertension, a major risk factor for renal impairment, also affects retinal microvasculature. This study investigates the relationship between retinal vascular density, assessed by Optical Coherence Tomography Angiography (OCT-A), and early renal dysfunction in hypertensive patients. A total of 142 hypertensive patients (mean age 47 ± 13 years; 74% male) were enrolled from the Nephrology and Hypertension Unit at the University of Palermo. Retinal vascular density was measured using OCT-A, and renal function was assessed using estimated glomerular filtration rate (eGFR). Clinical and hemodynamic parameters, including 24-h aortic blood pressure, were also analyzed. : Patients with eGFR < 60 mL/min/1.73 m exhibited significantly lower retinal vascular densities, particularly in the parafoveal region. Superficial parafoveal density was inversely associated with aortic pulse pressure ( = 0.012) and directly correlated with eGFR ( = 0.012). Deep parafoveal density was independently associated with eGFR ( = 0.001). Multiple linear regression confirmed that lower retinal vascular density was significantly linked to reduced renal function, independent of age and blood pressure. Retinal vascular density, particularly in the parafoveal region, is associated with renal function decline in hypertensive patients. These findings suggest that retinal microvascular changes could serve as a non-invasive biomarker for kidney dysfunction, with potential applications in early risk stratification and disease monitoring. Further research is needed to establish causality and clinical utility.
眼睛和肾脏在胚胎学、结构和病理生理学方面存在相似之处，这表明视网膜和肾脏微血管变化之间可能存在潜在联系。高血压是肾功能损害的主要危险因素，也会影响视网膜微血管系统。本研究调查了通过光学相干断层扫描血管造影（OCT-A）评估的视网膜血管密度与高血压患者早期肾功能障碍之间的关系。从巴勒莫大学的肾脏病和高血压科招募了142名高血压患者（平均年龄47±13岁；74%为男性）。使用OCT-A测量视网膜血管密度，并使用估计肾小球滤过率（eGFR）评估肾功能。还分析了包括24小时主动脉血压在内的临床和血流动力学参数。eGFR<60 mL/min/1.73 m²的患者视网膜血管密度显著降低，尤其是在黄斑旁区域。黄斑旁浅层密度与主动脉脉压呈负相关（r = 0.012），与eGFR呈正相关（r = 0.012）。黄斑旁深层密度与eGFR独立相关（r = 0.001）。多元线性回归证实，较低的视网膜血管密度与肾功能降低显著相关，独立于年龄和血压。视网膜血管密度，尤其是在黄斑旁区域，与高血压患者的肾功能下降有关。这些发现表明，视网膜微血管变化可作为肾功能障碍的非侵入性生物标志物，在早期风险分层和疾病监测中具有潜在应用价值。需要进一步研究以确定因果关系和临床实用性。
