4.4 Article

Retinopathy and the Risk of Cardiovascular Disease in Patients With Chronic Kidney Disease (from the Chronic Renal Insufficiency Cohort Study)

期刊

AMERICAN JOURNAL OF CARDIOLOGY
卷 116, 期 10, 页码 1527-1533

出版社

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2015.08.015

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资金

  1. National Institutes of Health [RO1 DK 74151]
  2. NIDDK [U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, U01DK060902]
  3. University of Pennsylvania Clinical and Translational Science Award NIH/NCATS [UL1TR000003]
  4. Johns Hopkins University [UL1 TR000424]
  5. University of Maryland GCRC [M01 RR-16500]
  6. Clinical and Translational Science Collaborative of Cleveland [UL1TR000439]
  7. Michigan Institute for Clinical and Health Research (MICHR) [UL1TR000433]
  8. University of Illinois at Chicago CTSA [UL1RR029879]
  9. Tulane University Translational Research in Hypertension and Renal Biology [P30GM103337]
  10. Kaiser Permanente NIH/NCRR UCSF-CTSI [UL1 RR-024131]
  11. Vivian S. Lasko Research Fund
  12. Nina C. Mackall Trust
  13. Research to Prevent Blindness

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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 macro-vascular 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. (C) 2015 Elsevier Inc. All rights reserved.

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