BACKGROUND: Microvascular disease is a major pathogenic factor for chronic kidney disease (CKD) in persons with diabetes, but the role of microvascular disease in the development of CKD in the general population is unclear. The aim of this study is to examine whether microvascular disease precedes the development of CKD stage 3 in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). STUDY DESIGN: Population-based cohort study. SETTING & PARTICIPANTS: MESA is a prospective cohort study of adults aged 45-84 years living in 6 US communities; 4,594 adults with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2) when they underwent retinal photography (visit 2: in 2002-2004) were examined. PREDICTOR: Retinal microvascular caliber measured from fundus photographs. OUTCOMES: Incident CKD stage 3 (ie, eGFR <60 mL/min/1.73 m(2)) at 2 subsequent follow-up examinations (visit 3 in 2004-2005, and visit 4 in 2005-2007) and an annual eGFR decrease >1 mL/min/1.73 m(2) computed using the CKD Epidemiology Collaboration (CKD-EPI) equation. RESULTS: After a median follow-up of 4.8 years, there were 232 incident CKD stage 3 cases. Overall, retinal microvascular caliber was not associated with incident CKD stage 3. However, in race-stratified analysis, narrower arterioles in whites was associated with a higher risk of developing CKD stage 3 after adjusting for age, sex, blood pressure, diabetes, and other factors (HR, 1.78; 95% CI, 1.01-3.15; P = 0.04, lowest vs highest arteriolar caliber tertile). This association was seen even in whites without hypertension and diabetes (HR, 2.95; 95% CI, 1.10-7.98; P = 0.03). Retinal arteriolar caliber was not associated with incident CKD stage 3 in African Americans, Chinese, or Hispanics. LIMITATIONS: Analyses were based on a single eGFR measurement, and retinal microvascular caliber and eGFR measurements were not ascertained concurrently. CONCLUSION: Microvascular changes as manifest in the eye may contribute to the development of CKD stage 3 in whites. Published by Elsevier Inc.
BACKGROUND:Microvascular disease is a major pathogenic factor for chronic kidney disease (CKD) in persons with diabetes, but the role of microvascular disease in the development of CKD in the general population is unclear. The aim of this study is to examine whether microvascular disease precedes the development of CKD stage 3 in participants of the Multi-Ethnic Study of Atherosclerosis (MESA). STUDY DESIGN: Population-based cohort study. SETTING & PARTICIPANTS: MESA is a prospective cohort study of adults aged 45-84 years living in 6 US communities; 4,594 adults with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2) when they underwent retinal photography (visit 2: in 2002-2004) were examined. PREDICTOR: Retinal microvascular caliber measured from fundus photographs. OUTCOMES: Incident CKD stage 3 (ie, eGFR <60 mL/min/1.73 m(2)) at 2 subsequent follow-up examinations (visit 3 in 2004-2005, and visit 4 in 2005-2007) and an annual eGFR decrease >1 mL/min/1.73 m(2) computed using the CKD Epidemiology Collaboration (CKD-EPI) equation. RESULTS: After a median follow-up of 4.8 years, there were 232 incident CKD stage 3 cases. Overall, retinal microvascular caliber was not associated with incident CKD stage 3. However, in race-stratified analysis, narrower arterioles in whites was associated with a higher risk of developing CKD stage 3 after adjusting for age, sex, blood pressure, diabetes, and other factors (HR, 1.78; 95% CI, 1.01-3.15; P = 0.04, lowest vs highest arteriolar caliber tertile). This association was seen even in whites without hypertension and diabetes (HR, 2.95; 95% CI, 1.10-7.98; P = 0.03). Retinal arteriolar caliber was not associated with incident CKD stage 3 in African Americans, Chinese, or Hispanics. LIMITATIONS: Analyses were based on a single eGFR measurement, and retinal microvascular caliber and eGFR measurements were not ascertained concurrently. CONCLUSION: Microvascular changes as manifest in the eye may contribute to the development of CKD stage 3 in whites. Published by Elsevier Inc.
Authors: Matthew S Edwards; David B Wilson; Timothy E Craven; Jeanette Stafford; Linda F Fried; Tien Y Wong; Ronald Klein; Gregory L Burke; Kimberley J Hansen Journal: Am J Kidney Dis Date: 2005-08 Impact factor: 8.860
Authors: M Nangaku; C E Alpers; J Pippin; S J Shankland; S Adler; K Kurokawa; W G Couser; R J Johnson Journal: Kidney Int Date: 1997-07 Impact factor: 10.612
Authors: A R Sharrett; L D Hubbard; L S Cooper; P D Sorlie; R J Brothers; F J Nieto; J L Pinsky; R Klein Journal: Am J Epidemiol Date: 1999-08-01 Impact factor: 4.897
Authors: Ronald Klein; Bernard Zinman; Robert Gardiner; Samy Suissa; Sandra M Donnelly; Alan R Sinaiko; Michael S Kramer; Paul Goodyer; Scot E Moss; Trudy Strand; Michael Mauer Journal: Diabetes Date: 2005-02 Impact factor: 9.461
Authors: Tien Yin Wong; Ronald Klein; F M Amirul Islam; Mary Frances Cotch; Aaron R Folsom; Barbara E K Klein; A Richey Sharrett; Steven Shea Journal: Am J Ophthalmol Date: 2006-03 Impact factor: 5.258
Authors: Rupal Mehta; Alexander Hodakowski; Xuan Cai; Kris E Lee; Bryan R Kestenbaum; Ian H de Boer; Amani Fawzi; Tien Yin Wong; Joachim Ix; Barbara Klein; Ronald Klein; Tamara Isakova Journal: Ophthalmic Epidemiol Date: 2017-04-12 Impact factor: 1.648
Authors: Luenda E Charles; Ja K Gu; Claudia C Ma; Lisa M Grady; Anna Mnatsakanova; Michael E Andrew; Desta Fekedulegn; John M Violanti; Ronald Klein Journal: J Occup Environ Med Date: 2017-10 Impact factor: 2.162
Authors: Kristine Yaffe; Lynn Ackerson; Tina D Hoang; Alan S Go; Maureen G Maguire; Gui-Shuang Ying; Ebenezer Daniel; Lydia A Bazzano; Martha Coleman; Debbie L Cohen; John W Kusek; Akinlolu Ojo; Stephen Seliger; Dawei Xie; Juan E Grunwald Journal: Am J Kidney Dis Date: 2012-12-01 Impact factor: 8.860
Authors: WanFen Yip; Charumathi Sabanayagam; Boon Wee Teo; Wan Ting Tay; M Kamran Ikram; E Shyong Tai; Khuan Yew Chow; Tien Y Wong; Carol Y Cheung Journal: PLoS One Date: 2015-02-06 Impact factor: 3.240
Authors: Weng Kit Lye; Euan Paterson; Christopher C Patterson; Alexander P Maxwell; Riswana Banu Binte Mohammed Abdul; E Shyong Tai; Ching Yu Cheng; Takamasa Kayama; Hidetoshi Yamashita; Mark Sarnak; Michael Shlipak; Kunihiro Matsushita; Unal Mutlu; Mohammad A Ikram; Caroline Klaver; Annette Kifley; Paul Mitchell; Chelsea Myers; Barbara E Klein; Ronald Klein; Tien Y Wong; Charumathi Sabanayagam; Gareth J McKay Journal: Kidney Int Date: 2020-08-15 Impact factor: 10.612