Retinal vascular signs as screening and prognostic factors for chronic kidney disease: A systematic review and meta-analysis of current evidence

Michael Aronov, Raviv Allon, Danielle Stave, Michael Belkin, Eyal Margalit, Ido Didi Fabian, Barak Rosenzweig

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The substantial burden of kidney disease fosters interest in new ways of screening for early disease diagnosis, especially by non-invasive imaging. Increasing evidence for an association between retinal microvascular signs and kidney disease prompted us to investigate the relevant current literature on such an association systematically by performing a meta-analysis of our findings. Methods: We scrutinized the current literature by searching PubMed and Embase databases from for clinical studies of the association between retinal microvascular signs and prevalent or incident kidney disease. After excluding cases that did not meet our criteria, we extracted relevant data from 42 published studies (9 prospective, 32 cross-sectional, and 1 retrospective). Results: Our investigation yielded significant associations between retinal vascular changes (including retinopathy and retinal vascular diameter) and kidney dysfunction (including chronic kidney disease (CKD), end-stage renal disease (ESRD), albuminuria, and estimated glomerular filtration rate (eGFR) decline). According to our meta-analysis, retinopathy was associated with ESRD (hazard ratio (HR) 2.12 (95% confidence interval CI; 1.39–3.22)) and with CKD prevalence in the general population (odds ratio (OR) 1.31 (95% CI; 1.14–1.50)), and specifically in type 2 diabetic patients (OR 1.68 (95% CI; 1.68–2.16)). CRAE was associated with prevalent CKD (OR 1.41 (95% CI; 1.09–1.82)). Conclusions: Our findings suggest that the retinal microvasculature can provide essential data about concurrent kidney disease status and predict future risk for kidney disease development and progression.

Original languageEnglish
Article number665
JournalJournal of Personalized Medicine
Volume11
Issue number7
DOIs
StatePublished - Jul 2021

Keywords

  • Chronic kidney disease
  • Diabetic retinopathy
  • End-stage renal disease
  • Fundus photography
  • Glomerular filtration rate
  • Retinal vascular diameter

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