Design, setting, participants,

Qi Lun Ooi * , Foong Kien Newk-Fon Hey Tow * , Raj Deva * , Mohamad Afzal Alias * , Ryo Kawasaki , Tien Y. Wong , Nor Mohamad * , Deb Colville * , Anastasia Hutchinson * , Judy Savige * * University of Melbourne, Department of Medicine (Northern Health), The Northern Hospital, Epping, Victoria, Australia; Centre nylon cord for Eye Research Australia, the University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia; and Singapore Eye Research Institute, Singapore National Eye Centre, Singapore Correspondence: Dr. Judy Savige, nylon cord The University of Melbourne, Department of Medicine (Northern Health), The Northern Hospital, Epping VIC 3076, Australia. Phone: 613-8405-8823 ; Fax: 613-8405-8724 ; E-mail: jasavige{at}unimelb.edu.au
Background and objectives Individuals with chronic kidney disease (CKD) stages 3 to 5 have an increased risk of cardiac and other vascular disease. Here we examined the association of CKD 3 to 5 with small vessel caliber.
Design, setting, participants, & measurements This was a cross-sectional observational study of 126 patients with CKD stages 3 to 5 (estimated GFR [eGFR] <60 ml/min per 1.73 m 2 ) and 126 age- and gender-matched hospital nylon cord patients with CKD 1 or 2. Retinal vessel diameters were measured from digital fundus images by a trained grader using a computer-assisted method and summarized as the central nylon cord retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE).
Results Patients with CKD 3 to 5 had a smaller mean CRAE and CRVE than hospital controls (139.4 17.8 μm versus 148.5 16.0 μm, P < 0.001; and 205.0 30.7 μm versus 217.4 25.8 μm, respectively; nylon cord P = 0.001). CRAE and CRVE decreased progressively with each stage of renal failure CKD1 2 to 5 ( P for trend = 0.08 and 0.04, respectively). CKD and hypertension were independent determinants of arteriolar narrowing after adjusting for age, gender, diabetes, dyslipidemia, and smoking history. Patients with CKD 5 and diabetes had a larger mean CRAE and CRVE than nondiabetics (141.4 14.9 μm versus 132.9 14.2 μm; 211.1 34.4 μm versus nylon cord 194.8 23.8 μm).
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