Статья

Vision-Threatening Retinal Abnormalities in Chronic Kidney Disease Stages 3 to 5

Rajeev DevaThe University of Melbourne, Department of Medicine, Northern Health, Cooper Street, Melbourne, Victoria 3076 AustraliaMohamad Afzal AliasThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaDeb ColvilleThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaFoong Kien Newk-Fon Hey TowThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaQi Lun OoiThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaSky ChewThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaNor Fadhilah MohamadThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaAnastasia HutchinsonThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaIgnatios KoukourasThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, AustraliaDavid A. PowerDepartment of Nephrology, Austin Health, Heidelberg, Victoria, AustraliaJudith SavigeThe University of Melbourne Department of Medicine, Northern Health, Melbourne, Victoria, Australia

2011en

ABI

Аннотация

BACKGROUND AND OBJECTIVES: Retinal abnormalities are common in inherited and acquired renal disease. This study determined the prevalence of retinal abnormalities in chronic kidney disease (CKD) stages 3 to 5. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: One hundred fifty patients with CKD stages 3 to 5 and 150 age- and gender-matched hospital patients with CKD stages 1 to 2 underwent bilateral retinal photography. These images were reviewed for incidental abnormalities, microvascular (Wong and Mitchell classification) and diabetic retinopathy (Airlie House criteria), and macular degeneration (Seddon classification). RESULTS: Three (2%) patients with CKD stages 3 to 5 had retinal features characteristic of inherited renal disease (atrophy in Myopathy, Encephalopathy, Lactic Acidosis, Stroke-like episodes [MELAS] syndrome; and 2 with drusen in dense deposit disease). Fifty-nine (39%) patients had moderate-severe microvascular retinopathy (hemorrhages, exudates, etc.) compared with 19 (13%) with CKD stages 1 to 2. Forty-one (28%) had moderate-severe diabetic retinopathy (microaneurysms, exudates, etc.) compared with 16 (11%) with CKD stages 1 to 2. Ten (7%) had severe macular degeneration (geographic atrophy, hemorrhage, exudates, membranes) compared with one (1%) with CKD stages 1 to 2. Renal failure was an independent risk factor for microvascular retinopathy, diabetic retinopathy, and macular degeneration. Eleven (7.3%) patients with renal failure and one (0.7%) with CKD stages 1 to 2 had previously unrecognized vision-threatening retinal abnormalities that required immediate ophthalmologic attention. CONCLUSIONS: Retinal abnormalities are common in CKD stages 3 to 5, and are more severe and more likely to threaten vision than in hospital patients with CKD stages 1 to 2.

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Идентификаторы

DOI: 10.2215/cjn.10321110

Цитирования и источники

Цитирований: 2Использованных источников: 0

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