Abstract: FR-PO292
Evaluation of Renal and Retinal Outcomes in the Northern Ireland Cohort of Longitudinal Ageing (NICOLA)
Session Information
- CKD: Epidemiology and Risk Factors
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- O'Neill, Rachael, Queen's University Belfast, Belfast, United Kingdom
- Maxwell, Alexander P., Queen's University Belfast, Belfast, United Kingdom
- Kee, Frank, Queen's University Belfast, Belfast, United Kingdom
- Young, Ian, Queen's University Belfast, Belfast, United Kingdom
- Mcguinness, Bernadette, Queen's University Belfast, Belfast, United Kingdom
- Hogg, Ruth E., Queen's University Belfast, Belfast, United Kingdom
- McKay, Gareth J., Queen's University Belfast, Belfast, United Kingdom
Background
Microvascular pathology is a common feature of both eye and kidney diseases. Renal microvascular damage is not easy to identify without renal biopsy. Advances in imaging the retinal microvasculature may offer an alternative opportunistic evaluation of microangiopathic changes that correlate with kidney dysfunction. Retinal imaging might provide an earlier, non-invasive screening assessment for the presence of chronic kidney disease (CKD). We assessed retinal microvascular parameters for association with against measures of renal function measures in a prospective cohort study of older persons (>55 years): Northern Ireland Cohort of Longitudinal Ageing (NICOLA).
Methods
Retinal microvascular parameters (central retinal arteriolar/ venular equivalents (CRAE/CRVE) arteriolar to venular ratio (AVR), fractal dimension and tortuosity) were measured from optic disc centered fundus images and analysed using semi-automated software. Linear and logistic regression models were used to assess associations between microvascular parameters and the continuous variables of renal function (eGFR Creatinine (SeCr) and Cystatin C (Scys)) and the binary trait of CKD status, respectively. Minimally adjusted models included age and gender with fully adjusted models also including diabetes, smoking, alcohol, education, body mass index, antihypertensive medication, mean arterial blood pressure, triglycerides, high and low-density lipoproteins.
Results
Retinal and renal measures were available for 1,860 of the 3,518 NICOLA participants. In unadjusted, minimally adjusted and fully adjusted linear regression models, no significant associations were detected between CRAE, CRVE, AVR, fractal dimension or tortuosity and eGFRSeCr or eGFRScys.
CKD status, defined by eGFRSeCr < 60 mL/min per 1.73 m2, was significantly associated with venular tortuosity in all models (β=0.8; 95%CI: 1.3, 4.1; P=0.004). There was no significant associations detected between CKD status and any of the other retinal parameters assessed.
Conclusion
Our findings indicate that variation in retinal venular geometry is associated with renal dysfunction in an older population . These non-invasive retinal measures may help identify early mechanistic pathways for microvascular complications in individuals at high risk for future CKD.
Funding
- Government Support - Non-U.S.