Looking into the Eyes to See the Heart of Chronic Kidney Disease Patients

Autores de IDIVAL

• 

  María Kislikova

  Autor

• Jorge Javier Gaitan Valdizan

  Autor

• 

  José Antonio Parra Blanco

  Autor

• 

  María Teresa García Unzueta

  Autor

• 

  Vicente Celestino Piñera Haces

  Autor

• Maria De La Oliva Valentin Muñoz

  Autor

• Adalberto Benito Hernández

  Autor

• 

  Juan Carlos Ruíz San Millán

  Autor

• 

  Emilio Rodrigo Calabia

  Autor

Autores ajenos al IDIVAL

• Rodríguez Vidriales M
• Escagedo Cagigas C

Unidades

• DIAGNÓSTICO Y TRATAMIENTO POR IMAGEN

  

  Investigador Responsable

  Elena Carmen Gallardo Agromayor

• INMUNOPATOLOGÍA

  

  Investigador Corresponsable

  Ricardo Blanco Alonso

• INVESTIGACIÓN CARDIOVASCULAR

  

  Investigador Responsable

  José María De La Torre Hernández

Abstract

In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart disease, thereby indicating a higher cardiovascular risk profile. Our study aimed to investigate the utility of these techniques in the CKD population. In patients with CKD, OCT was used to measure the choroidal thickness (CHT) and the thickness of the peripapillary retinal nerve fiber layer (pRNFL). A total of 127 patients were included, including 70 men (55%) with an estimated glomerular filtration rate (eGFR) of 39 +/- 30 mL/min/1.73 m(2). Lower pRNFL thickness was found to be related to high-sensitivity troponin I (r = -0.362, p < 0.001) and total coronary calcification (r = -0.194, p = 0.032). In a multivariate analysis, pRNFL measurements remained associated with age (beta = -0.189; -0.739--0.027; p = 0.035) and high-sensitivity troponin I (beta = -0.301; -0.259--0.071; p < 0.001). Severe coronary calcification (Agatston score >= 400 HU) was related to a worse eGFR (p = 0.008), a higher grade of CKD (p = 0.036), and a thinner pRNFL (p = 0.011). The ROC curve confirmed that the pRNFL measurement could determine the patients with an Agatston score of >= 400 HU (AUC 0.638; 95% CI 0.525-0.750; p = 0.015). Our study concludes that measurement of pRNFL thickness using OCT is related to the markers associated with ischemic heart disease, such as coronary calcification and high-sensitivity troponin I, in the CKD population.

Keywords

• CKD; choroid; retinal nerve; cardiac disease; coronary disease; troponin