Progression of retinal, chronic kidney disease may be influenced by similar risk factors
It is possible that similar mechanisms mediate the progression of both retinopathy and chronic kidney disease (CKD), with a recent study showing that the association between the two progression events found on initial analysis has disappeared after adjusting for known risk factors for both diseases.
Researchers looked at 1,936 patients with CKD enrolled in the multicentre, prospective Chronic Renal Insufficiency Cohort (CRIC) Study. Of these, 1,583 attended nonmydriatic fundus photography session at baseline, and 1,025 had follow-up photography taken after a mean of 3.5 years.
Among 1,025 participants who had baseline and follow-up photographs, 930 (90.7 percent) showed no retinopathy progression, 26 (2.5 percent) showed 2-step worsening, 32 (3.1 percent) showed 3-step worsening, and 37 (3.6 percent) showed more than 3-step worsening.
End-stage renal disease (ESRD) or 50-percent decrease in estimated glomerular filtration rate (eGFR) occurred in 88 of 930 participants who had no retinopathy progression and in 18 of 95 participants with retinopathy progression.
Univariable logistic regression analysis revealed that worsening of retinopathy, as opposed to stable retinopathy, was associated with a twofold likelihood of CKD progression (odds ratio [OR], 2.24, 95 percent CI, 1.28–3.91; p=0.005). This association disappeared upon further adjustments for known risk factors for both diseases (OR, 1.62, 0.77–3.39; p=0.20).
The fact that the association became negligible in multivariable regression models implies that progression of CKD and retinopathy may be influenced by similar risk factors, the researchers pointed out. Additionally, the findings suggest substantial prevalence and progression of retinopathy in participants with CKD, supporting vigilance for monitoring eye disease in patients with CKD.