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Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis.

Publication ,  Journal Article
Awua-Larbi, S; Wong, TY; Cotch, MF; Durazo-Arvizu, R; Jacobs, DR; Klein, BEK; Klein, R; Lima, J; Liu, K; Kramer, H
Published in: Nephrol Dial Transplant
November 2011

BACKGROUND: Changes in retinal microvascular caliber, which occur prior to onset of retinopathy, may indicate presence of kidney damage. METHODS: This study examined the association between retinal arteriolar [central retinal artery equivalent (CRAE)] and venular caliber [central retinal venule equivalent (CRVE)] and presence of albuminuria (micro- or macroalbuminuria) among participants of the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort of adults aged 45-84 years without baseline clinical cardiovascular disease. During the second MESA exam, digital fundus photography was completed in 5897 participants who provided spot urine specimens. Albuminuria was defined by spot urine albumin/creatinine ratios ≥ 30 mg/g. Multivariable adjusted odds of albuminuria by quintiles of CRAE and CRVE were determined using logistic regression. Analyses were repeated after stratifying by presence of type 2 diabetes. RESULTS: Albuminuria was noted in 11.5% (n = 675) and included 584 subjects with microalbuminuria and 91 with macroalbuminuria. A significant U-shaped pattern was seen with higher prevalence of albuminuria across quintile extremes in CRAE (15.7, 8.8 and 10.6% in CRAE Quintiles 1, 3 and 5, respectively; P <0.0001). After adjustment for covariates, both narrower CRAE [odds ratios (OR) 1.55; 95% confidence interval (CI) 1.17-2.04, Quintile 1 versus 3) and wider CRAE (OR 1.44; 95% CI 1.07-1.93, Quintile 5 versus 3) were significantly associated with albuminuria. Associations appeared substantially stronger in adults with than without type 2 diabetes but the interaction term for diabetes and CRAE on presence of albuminuria did not meet statistical significance (P = 0.3). No association was noted between CRVE quintiles and albuminuria. CONCLUSIONS: Albuminuria is associated with narrower and wider arteriolar caliber. Future studies should determine whether variation in arteriolar caliber predicts incident albuminuria and whether associations are mediated by hypertension and diabetes. Such information could further clarify early microvascular processes in the pathogenesis of kidney disease.

Duke Scholars

Published In

Nephrol Dial Transplant

DOI

EISSN

1460-2385

Publication Date

November 2011

Volume

26

Issue

11

Start / End Page

3523 / 3528

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Survival Rate
  • Risk Factors
  • Retinal Diseases
  • Prevalence
  • Middle Aged
  • Male
  • Kidney Diseases
  • Hypertension
  • Humans
 

Citation

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MLA
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Awua-Larbi, S., Wong, T. Y., Cotch, M. F., Durazo-Arvizu, R., Jacobs, D. R., Klein, B. E. K., … Kramer, H. (2011). Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis. Nephrol Dial Transplant, 26(11), 3523–3528. https://doi.org/10.1093/ndt/gfr095
Awua-Larbi, Stella, Tien Y. Wong, Mary Frances Cotch, Ramon Durazo-Arvizu, David R. Jacobs, Barbara E. K. Klein, Ronald Klein, Joao Lima, Kiang Liu, and Holly Kramer. “Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis.Nephrol Dial Transplant 26, no. 11 (November 2011): 3523–28. https://doi.org/10.1093/ndt/gfr095.
Awua-Larbi S, Wong TY, Cotch MF, Durazo-Arvizu R, Jacobs DR, Klein BEK, et al. Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis. Nephrol Dial Transplant. 2011 Nov;26(11):3523–8.
Awua-Larbi, Stella, et al. “Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis.Nephrol Dial Transplant, vol. 26, no. 11, Nov. 2011, pp. 3523–28. Pubmed, doi:10.1093/ndt/gfr095.
Awua-Larbi S, Wong TY, Cotch MF, Durazo-Arvizu R, Jacobs DR, Klein BEK, Klein R, Lima J, Liu K, Kramer H. Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis. Nephrol Dial Transplant. 2011 Nov;26(11):3523–3528.
Journal cover image

Published In

Nephrol Dial Transplant

DOI

EISSN

1460-2385

Publication Date

November 2011

Volume

26

Issue

11

Start / End Page

3523 / 3528

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Survival Rate
  • Risk Factors
  • Retinal Diseases
  • Prevalence
  • Middle Aged
  • Male
  • Kidney Diseases
  • Hypertension
  • Humans