Patients with chronic kidney disease (CKD) experience other diseases such as cardiovascular
disease (CVD) and retinopathy. The purpose of this study was to assess whether retinopathy
predicts future CVD events in a subgroup of the participants of the Chronic Renal
Insufficiency Cohort (CRIC) study. In this ancillary investigation, 2,605 participants
of the CRIC study were invited to participate, and nonmydriatic fundus photographs
were obtained in 1,936 subjects. Using standard protocols, presence and severity of
retinopathy (diabetic, hypertensive, or other) and vessel diameter caliber were assessed
at a central photograph reading center by trained graders masked to study participant's
information. Patients with a self-reported history of cardiovascular disease were
excluded. Incident CVD events were adjudicated using medical records. Kidney function
measurements, traditional and nontraditional risk factors, for CVD were obtained.
Presence and severity of retinopathy were associated with increased risk of development
of any CVD in this population of CKD patients, and these associations persisted after
adjustment for traditional risk factors for CVD. We also found a direct relation between
increased venular diameter and risk of development of CVD; however, the relation was
not statistically significant after adjustment for traditional risk factors. In conclusion,
the presence of retinopathy was associated with future CVD events, suggesting that
retinovascular pathology may be indicative of macrovascular disease even after adjustment
for renal dysfunction and traditional CVD risk factors. Assessment of retinal morphology
may be valuable in assessing risk of CVD in patients with CKD, both clinically and
in research settings.
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Article info
Publication history
Published online: August 31, 2015
Accepted:
August 18,
2015
Received in revised form:
August 18,
2015
Received:
May 20,
2015
Footnotes
Funding: This study was supported by Grant RO1 DK 74151 from National Institutes of Health. CRIC was funded by Grants U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, and U01DK060902 from NIDDK cooperative agreements, Grant UL1TR000003 from University of Pennsylvania Clinical and Translational Science Award NIH/NCATS, Grant UL1 TR-000424 from Johns Hopkins University, Grant M01 RR-16500 from University of Maryland GCRC, Grant UL1TR000439 from Clinical and Translational Science Collaborative of Cleveland, Grant UL1TR000433 from Michigan Institute for Clinical and Health Research (MICHR), Grant UL1RR029879 from University of Illinois at Chicago CTSA, Grant P30GM103337 from Tulane University Translational Research in Hypertension and Renal Biology, Grant UL1 RR-024131 from Kaiser Permanente NIH/NCRR UCSF-CTSI, Vivian S. Lasko Research Fund, Nina C. Mackall Trust, and Research to Prevent Blindness.
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© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
