Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients
Background: Widespread neural and microvascular injuries are common in chronic kidney disease (CKD), increasing risks of neurovascular complications and mortality. Early detection of such changes helps assess the risks of neurovascular complications for CKD patients. As an extension of central nervo...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2021.703898/full |
| _version_ | 1818402057383575552 |
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| author | Xiaomin Zeng Xiaomin Zeng Yijun Hu Yijun Hu Yuanhan Chen Zhanjie Lin Zhanjie Lin Yingying Liang Yingying Liang Baoyi Liu Baoyi Liu Pingting Zhong Pingting Zhong Yu Xiao Yu Xiao Cong Li Cong Li Guanrong Wu Guanrong Wu Huiqian Kong Huiqian Kong Zijing Du Zijing Du Yun Ren Yun Ren Ying Fang Zhiming Ye Xiaohong Yang Xiaohong Yang Honghua Yu Honghua Yu |
| author_facet | Xiaomin Zeng Xiaomin Zeng Yijun Hu Yijun Hu Yuanhan Chen Zhanjie Lin Zhanjie Lin Yingying Liang Yingying Liang Baoyi Liu Baoyi Liu Pingting Zhong Pingting Zhong Yu Xiao Yu Xiao Cong Li Cong Li Guanrong Wu Guanrong Wu Huiqian Kong Huiqian Kong Zijing Du Zijing Du Yun Ren Yun Ren Ying Fang Zhiming Ye Xiaohong Yang Xiaohong Yang Honghua Yu Honghua Yu |
| author_sort | Xiaomin Zeng |
| collection | DOAJ |
| description | Background: Widespread neural and microvascular injuries are common in chronic kidney disease (CKD), increasing risks of neurovascular complications and mortality. Early detection of such changes helps assess the risks of neurovascular complications for CKD patients. As an extension of central nervous system, the retina provides a characteristic window to observe neurovascular alterations in CKD. This study aimed to determine the presence of retinal neurovascular impairment in different stages of CKD.Methods: One hundred fifteen non-diabetic and non-dialytic CKD patients of all stages and a control group of 35 healthy subjects were included. Retinal neural and microvascular parameters were obtained by optical coherence tomography angiography (OCTA) examination.Results: CKD 1–2 group (versus control group) had greater odds of having decreased retinal ganglion cell-inner plexiform layer thickness (GC-IPLt) (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.86–0.98), increased ganglion cell complex-focal loss volume (GCC-FLV) (OR: 3.51; 95% CI: 1.27–9.67), and GCC-global loss volume (GCC-GLV) (OR: 2.48; 95% CI: 1.27–4.82). The presence of advanced stages of CKD (CKD 3–5 group versus CKD 1–2 group) had greater odds of having decreased retinal vessel density in superficial vascular plexus (SVP)-WholeImage (OR: 0.77, 95% CI: 0.63–0.92), SVP-ParaFovea (OR: 0.83, 95% CI: 0.71–0.97), SVP-ParaFovea (OR: 0.76, 95% CI: 0.63–0.91), deep vascular plexus (DVP)-WholeImage (OR: 0.89, 95% CI: 0.81–0.98), DVP-ParaFovea (OR: 0.88, 95% CI: 0.78–0.99), and DVP-PeriFovea (OR: 0.90, 95% CI: 0.83–0.98). Besides, stepwise multivariate linear regression among CKD patients showed that β2-microglobulin was negatively associated with GC-IPLt (β: –0.294; 95% CI: –0.469 ∼ –0.118), and parathyroid hormone was positively associated with increased GCC-FLV (β: 0.004; 95% CI: 0.002∼0.006) and GCC-GLV (β: 0.007; 95% CI: 0.004∼0.01). Urine protein to creatinine ratio was positively associated with increased GCC-FLV (β: 0.003; 95% CI: 0.001∼0.004) and GCC-GLV (β: 0.003; 95% CI: 0.001∼0.006).Conclusion: Retinal neuronal impairment is present in early stages of CKD (stages 1–2), and it is associated with accumulation of uremic toxins and higher UACR, while retinal microvascular hypoperfusion, which is associated with worse eGFR, was only observed in relatively advanced stages of CKD (stages 3–5). The results highlight the importance of monitoring retinal neurovascular impairment in different stages of CKD. |
| first_indexed | 2024-12-14T08:02:19Z |
| format | Article |
| id | doaj.art-1dd9c39fa407474a82dd245b1954614d |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-14T08:02:19Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-1dd9c39fa407474a82dd245b1954614d2022-12-21T23:10:19ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2021-11-011510.3389/fnins.2021.703898703898Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease PatientsXiaomin Zeng0Xiaomin Zeng1Yijun Hu2Yijun Hu3Yuanhan Chen4Zhanjie Lin5Zhanjie Lin6Yingying Liang7Yingying Liang8Baoyi Liu9Baoyi Liu10Pingting Zhong11Pingting Zhong12Yu Xiao13Yu Xiao14Cong Li15Cong Li16Guanrong Wu17Guanrong Wu18Huiqian Kong19Huiqian Kong20Zijing Du21Zijing Du22Yun Ren23Yun Ren24Ying Fang25Zhiming Ye26Xiaohong Yang27Xiaohong Yang28Honghua Yu29Honghua Yu30Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaAier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, ChinaAier School of Ophthalmology, Central South University, Changsha, ChinaDivision of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaShantou University Medical College, Shantou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaShantou University Medical College, Shantou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaShantou University Medical College, Shantou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaDivision of Nephrology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaBackground: Widespread neural and microvascular injuries are common in chronic kidney disease (CKD), increasing risks of neurovascular complications and mortality. Early detection of such changes helps assess the risks of neurovascular complications for CKD patients. As an extension of central nervous system, the retina provides a characteristic window to observe neurovascular alterations in CKD. This study aimed to determine the presence of retinal neurovascular impairment in different stages of CKD.Methods: One hundred fifteen non-diabetic and non-dialytic CKD patients of all stages and a control group of 35 healthy subjects were included. Retinal neural and microvascular parameters were obtained by optical coherence tomography angiography (OCTA) examination.Results: CKD 1–2 group (versus control group) had greater odds of having decreased retinal ganglion cell-inner plexiform layer thickness (GC-IPLt) (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.86–0.98), increased ganglion cell complex-focal loss volume (GCC-FLV) (OR: 3.51; 95% CI: 1.27–9.67), and GCC-global loss volume (GCC-GLV) (OR: 2.48; 95% CI: 1.27–4.82). The presence of advanced stages of CKD (CKD 3–5 group versus CKD 1–2 group) had greater odds of having decreased retinal vessel density in superficial vascular plexus (SVP)-WholeImage (OR: 0.77, 95% CI: 0.63–0.92), SVP-ParaFovea (OR: 0.83, 95% CI: 0.71–0.97), SVP-ParaFovea (OR: 0.76, 95% CI: 0.63–0.91), deep vascular plexus (DVP)-WholeImage (OR: 0.89, 95% CI: 0.81–0.98), DVP-ParaFovea (OR: 0.88, 95% CI: 0.78–0.99), and DVP-PeriFovea (OR: 0.90, 95% CI: 0.83–0.98). Besides, stepwise multivariate linear regression among CKD patients showed that β2-microglobulin was negatively associated with GC-IPLt (β: –0.294; 95% CI: –0.469 ∼ –0.118), and parathyroid hormone was positively associated with increased GCC-FLV (β: 0.004; 95% CI: 0.002∼0.006) and GCC-GLV (β: 0.007; 95% CI: 0.004∼0.01). Urine protein to creatinine ratio was positively associated with increased GCC-FLV (β: 0.003; 95% CI: 0.001∼0.004) and GCC-GLV (β: 0.003; 95% CI: 0.001∼0.006).Conclusion: Retinal neuronal impairment is present in early stages of CKD (stages 1–2), and it is associated with accumulation of uremic toxins and higher UACR, while retinal microvascular hypoperfusion, which is associated with worse eGFR, was only observed in relatively advanced stages of CKD (stages 3–5). The results highlight the importance of monitoring retinal neurovascular impairment in different stages of CKD.https://www.frontiersin.org/articles/10.3389/fnins.2021.703898/fullretinal imagingneuronal impairmentmicrovascular hypoperfusionoptical coherence tomography angiography (OCTA)chronic kidney disease |
| spellingShingle | Xiaomin Zeng Xiaomin Zeng Yijun Hu Yijun Hu Yuanhan Chen Zhanjie Lin Zhanjie Lin Yingying Liang Yingying Liang Baoyi Liu Baoyi Liu Pingting Zhong Pingting Zhong Yu Xiao Yu Xiao Cong Li Cong Li Guanrong Wu Guanrong Wu Huiqian Kong Huiqian Kong Zijing Du Zijing Du Yun Ren Yun Ren Ying Fang Zhiming Ye Xiaohong Yang Xiaohong Yang Honghua Yu Honghua Yu Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients Frontiers in Neuroscience retinal imaging neuronal impairment microvascular hypoperfusion optical coherence tomography angiography (OCTA) chronic kidney disease |
| title | Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients |
| title_full | Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients |
| title_fullStr | Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients |
| title_full_unstemmed | Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients |
| title_short | Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients |
| title_sort | retinal neurovascular impairment in non diabetic and non dialytic chronic kidney disease patients |
| topic | retinal imaging neuronal impairment microvascular hypoperfusion optical coherence tomography angiography (OCTA) chronic kidney disease |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2021.703898/full |
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