Retinopathy linked to CKD and ESKD risk factors, suggesting underlying mechanism
Patients with retinopathy had a higher prevalence of kidney disease and exhibited greater risk for incident chronic kidney disease, end-stage kidney disease and coronary heart disease, according to results published in Kidney Medicine.
Researchers noted that the association implies the existence of similar pathological mechanisms underlying retinopathy and other diabetes outcomes. Also, the findings “might suggest that prevention and early diagnosis of microvascular disease could improve other clinical outcomes in diabetes,” Jingyao Hong, MHS, of the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, and colleagues wrote.
The retrospective cohort study involved 15,792 individuals aged 45 to 64 years from four U.S. communities between 1987 and 1989. Hong and colleagues conducted follow-up examinations every 3 years for a median follow-up of 14.2 years. Researchers assessed the impact of retinopathy on CKD, ESKD, coronary heart disease (CHD) and stroke prevalence
While 1,759 participants developed diabetes, 508 were diagnosed with retinopathy. Of the patients who developed diabetes, the mean age was 63.4 years and women accounted for 51.2% of the group. The development of retinopathy occurred more often in patients who were older, Black and who used insulin. Participants with retinopathy had higher blood pressure and fasting glucose but lower eGFR. Also, retinopathy was associated with risk of incident CKD (hazard ratio = 1.22), ESKD (HR = 1.69), CHD (HR = 1.46) and stroke (HR = 1.43), according to Hong and colleagues. Patients with any level of retinopathy experienced a higher risk for CKD. However, the association between retinopathy and CHD risk was stronger.
“Our finding of an association between retinopathy and kidney disease is consistent with previous studies in other populations of adults with diabetes. It has been reported that the kidney and eye share a similar structure of the vascular networks, developmental pathways, and pathological progression,” the researchers wrote. Hong and colleagues added, “There are many common pathologic mechanisms for kidney and eye diseases, including atherosclerosis, endothelial dysfunction, oxidative stress and inflammation.”