Document Detail


Association between retinopathy and cardiovascular disease in patients with chronic kidney disease (from the Chronic Renal Insufficiency Cohort [CRIC] Study).
MedLine Citation:
PMID:  22516527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with chronic kidney disease experience co-morbid illnesses, including cardiovascular disease (CVD) and retinopathy. The purpose of the present study was to assess the association between retinopathy and self-reported CVD in a subgroup of the participants in the Chronic Renal Insufficiency Cohort study. For this observational, ancillary investigation, 2,605 Chronic Renal Insufficiency Cohort participants were invited to participate in the present study, and nonmydriatic fundus photographs in both eyes were obtained for 1,936 subjects. The photographs were reviewed in a masked fashion at a central photograph reading center. The presence and severity of retinopathy (diabetic, hypertensive, or other) and vessel diameter caliber were assessed using standard protocols by trained graders who were masked to the information about the study participants. A history of self-reported CVD was obtained using a medical history questionnaire. Kidney function measurements and traditional and nontraditional risk factors for CVD were obtained from the Chronic Renal Insufficiency Cohort study. A greater severity of retinopathy was associated with a greater prevalence of any CVD, and this association persisted after adjustment for the traditional risk factors for CVD. The presence of vascular abnormalities usually associated with hypertension was also associated with increased prevalence of CVD. We found a direct relation between CVD prevalence and mean venular caliber. In conclusion, the presence of retinopathy was associated with CVD, suggesting that retinovascular pathology might indicate macrovascular disease, even after adjustment for renal dysfunction and traditional CVD risk factors. This would make the assessment of retinal morphology a valuable tool in CKD studies of CVD outcomes.
Authors:
Juan E Grunwald; Gui-Shuang Ying; Maureen Maguire; Maxwell Pistilli; Ebenezer Daniel; Judith Alexander; Revell Whittock-Martin; Candace Parker; Emile Mohler; Joan Chia-Mei Lo; Raymond Townsend; Crystal Ann Gadegbeku; James Phillip Lash; Jeffrey Craig Fink; Mahboob Rahman; Harold Feldman; John Walter Kusek; Dawei Xie; Martha Coleman; Martin Gerard Keane;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2012-04-18
Journal Detail:
Title:  The American journal of cardiology     Volume:  110     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-26     Completed Date:  2012-09-25     Revised Date:  2013-07-19    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-53     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. juangrun@mail.med.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / epidemiology*
Cohort Studies
Diabetic Retinopathy / epidemiology*
Female
Fluorescein Angiography
Humans
Hypertensive Retinopathy / epidemiology*
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / epidemiology
Myocardial Revascularization / statistics & numerical data
Renal Insufficiency, Chronic / epidemiology*
Retinal Vessels / pathology
Severity of Illness Index
Stroke / epidemiology
United States / epidemiology
Grant Support
ID/Acronym/Agency:
M01 RR013987/RR/NCRR NIH HHS; MO1 RR-000042/RR/NCRR NIH HHS; MO1 RR-16500/RR/NCRR NIH HHS; R01 DK 74151/DK/NIDDK NIH HHS; R01 DK074151-01/DK/NIDDK NIH HHS; R01 DK074151-02/DK/NIDDK NIH HHS; R01 DK074151-03/DK/NIDDK NIH HHS; R01 DK074151-04/DK/NIDDK NIH HHS; R01 DK074151-04S1/DK/NIDDK NIH HHS; R01 DK074151-05/DK/NIDDK NIH HHS; U01 DK060980/DK/NIDDK NIH HHS; U01-DK060990/DK/NIDDK NIH HHS; UL1 RR-024131/RR/NCRR NIH HHS; UL1 RR-024134/RR/NCRR NIH HHS; UL1 RR-024986/RR/NCRR NIH HHS; UL1 RR-024989/RR/NCRR NIH HHS; UL1 RR-029879/RR/NCRR NIH HHS; UL1 RR024989/RR/NCRR NIH HHS; UL1 RR029879/RR/NCRR NIH HHS
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