July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Association between retinal microvascular caliber and chronic kidney disease: participant-level and aggregate-data meta-analyses
Author Affiliations & Notes
  • Charumathi Sabanayagam
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
  • Weng Kit Lye
    Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
  • Riswana Banu
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  • E Shyong Tai
    Division of Endocrinology, National University Hospital, Singapore, Singapore
  • Takamasa Kayama
    Yamagata University Hospital, Japan, Japan
  • Michael Shlipak
    Kidney Health Research Collaborative, UCSF School of Medicine, San Francisco, California, United States
  • Arfan Ikram
    Erasmus University Medical Center, Rotterdam, Netherlands
  • Jonathan Shaw
    Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
  • Paul Mitchell
    Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
  • Barbara E K Klein
    Department of Ophthalmology & Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
  • Ronald Klein
    Department of Ophthalmology & Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
  • Kunihiro Matsushita
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Alexander Maxwell
    Queen's University Belfast, Belfast, United Kingdom
  • Christopher Patterson
    Queen's University Belfast, Belfast, United Kingdom
  • Tien Yin Wong
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Ophthalmology and Visual Sciences Academic Clinical Program, National University of Singapore, Singapore, Singapore
  • Gareth Mckay
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
  • Footnotes
    Commercial Relationships   Charumathi Sabanayagam, None; Weng Kit Lye, None; Riswana Banu, None; E Shyong Tai, None; Takamasa Kayama, None; Michael Shlipak, None; Arfan Ikram, None; Jonathan Shaw, None; Paul Mitchell, None; Barbara Klein, None; Ronald Klein, None; Kunihiro Matsushita, None; Alexander Maxwell, None; Christopher Patterson, None; Tien Wong, None; Gareth Mckay, None
  • Footnotes
    Support  (Medical Research Council UK Grant MR/K003364/1), (Duke-NUS-KMRA/2015/0003), (NMRC/STaR/016/2013)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2567. doi:
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      Charumathi Sabanayagam, Weng Kit Lye, Riswana Banu, E Shyong Tai, Takamasa Kayama, Michael Shlipak, Arfan Ikram, Jonathan Shaw, Paul Mitchell, Barbara E K Klein, Ronald Klein, Kunihiro Matsushita, Alexander Maxwell, Christopher Patterson, Tien Yin Wong, Gareth Mckay; Association between retinal microvascular caliber and chronic kidney disease: participant-level and aggregate-data meta-analyses. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2567.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The caliber of the retinal vessels has been linked to chronic kidney disease (CKD) but studies have not shown consistent results. We conducted meta-analyses using 1) individual participant data (IPD-MA, flexible and more powerful) and 2) aggregate data (AD-MA, based on summary estimates) to evaluate the cross-sectional association between retinal vessel calibers and CKD.

Methods : We performed a systematic review on Medline for articles published up to October 2017. For IPD-MA, we used one-stage approach combining raw data from 10 studies (5 from Asia, 3 from USA, 2 from Australia, n=35,090) and for the AD-MA we used two-stage approach combining summary estimates from 14 studies (including the above 10 studies+ 3 USA and 1 European study, n=47,589). CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2. Retinal arteriolar and venular calibers (central retinal arteriolar equivalent [CRAE] and central retinal venular equivalent [CRVE]) were assessed from retinal photographs using computer-assisted methods. We used logistic regression models to estimate pooled odds ratios (OR) of CKD associated with 1 standard deviation (SD, 20-µm) increase in CRAE and CRVE measurements.

Results : Prevalence of CKD was 11.7% (n=4100) and 12% (n=5694) in the IPD-MA and AD-MA respectively. After adjustment for age, sex, ethnicity, education, current smoking, diabetes, hypertension, body mass index, total cholesterol, and fellow vessel caliber, in IPD-MA, both CRAE and CRVE were significantly associated with CKD (pooled OR 1.12 [95% confidence interval (CI):1.07, 1.17] per SD increase in CRAE and 1.27 [1.22,1.32] for CRVE). However, in the AD-MA (14 cohorts), neither CRAE nor CRVE were significantly associated with CKD (0.94 [0.86,1.03] for CRAE and 0.99 [0.94, 1.04] for CRVE. Similar non-significant associations were observed in AD-MA including summary estimates from the 10 IPD-MA cohorts.

Conclusions : Our meta-analysis showed no consistent association between retinal vessel widths and CKD; wider retinal arterioles and venules were associated with CKD in IPD-MA but not in AD-MA. Longitudinal studies may clarify the association.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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