Prognostic value of the wall-to-lumen ratio of retinal arteries in patients with end-stage chronic kidney disease

IF 2.7 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Microvascular research Pub Date : 2025-08-20 DOI:10.1016/j.mvr.2025.104860

Céline Faure , Cindy Castrale , Anaïs Benabed , Romain Lezé , Pauline Cognard , Michel Paques

{"title":"Prognostic value of the wall-to-lumen ratio of retinal arteries in patients with end-stage chronic kidney disease","authors":"Céline Faure , Cindy Castrale , Anaïs Benabed , Romain Lezé , Pauline Cognard , Michel Paques","doi":"10.1016/j.mvr.2025.104860","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the hypothesis that the wall-to-lumen ratio (WLR) of retinal arteries is predictive of morbidity and mortality in patients with end-stage chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>Prospective single center clinical study. In 83 patients with CKD (average age (±SD) 75.8 (±11.4) years), arterial metrics in the retinal vasculature were measured using adaptive optics ophthalmoscopy (AOO; rtx1, ImagineEyes, France). Multivariate analysis including vascular metrics and biological parameters was done to identify predictive risk factors of the morbidity and mortality rates at 3 years.</div></div><div><h3>Results</h3><div>At inclusion, the mean (±SD) wall-to-lumen ratio (WLR) was 0,34 (± 0,17). No correlation was found between blood pressure and the WLR. The 1, 2 and 3-year survival rates were 74.7 %, 57.3 % and 42.1 %, respectively. The 1, 2 and 3-year rates of nonfatal cardiovascular events were 25.3 %, 42.7 % and 56.5 %, respectively. Four patients were lost to follow-up. Based on a Cox model, the cumulative 3-year relative risk of death or cardiovascular event was inversely correlated to the initial WLR (RR 2.5 if WLR <0.36, 2.1 if <0.3, 4.9 if <0.27), age over 80 years (RR 1.9), and sedentarity (RR 2.3). Metabolic factors were not predictive of event-free survival.</div></div><div><h3>Conclusions</h3><div>In patients with end-stage CKD, a lower WLR is associated with a higher morbidity and mortality rate at 3 years. Retinal vascular metrics may therefore provide novel biomarkers for the prediction of event-free survival in CKD. Additional studies are necessary to elucidate the underlying relationship.</div></div>","PeriodicalId":18534,"journal":{"name":"Microvascular research","volume":"162 ","pages":"Article 104860"},"PeriodicalIF":2.7000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Microvascular research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0026286225000792","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To investigate the hypothesis that the wall-to-lumen ratio (WLR) of retinal arteries is predictive of morbidity and mortality in patients with end-stage chronic kidney disease (CKD).

Methods

Prospective single center clinical study. In 83 patients with CKD (average age (±SD) 75.8 (±11.4) years), arterial metrics in the retinal vasculature were measured using adaptive optics ophthalmoscopy (AOO; rtx1, ImagineEyes, France). Multivariate analysis including vascular metrics and biological parameters was done to identify predictive risk factors of the morbidity and mortality rates at 3 years.

Results

At inclusion, the mean (±SD) wall-to-lumen ratio (WLR) was 0,34 (± 0,17). No correlation was found between blood pressure and the WLR. The 1, 2 and 3-year survival rates were 74.7 %, 57.3 % and 42.1 %, respectively. The 1, 2 and 3-year rates of nonfatal cardiovascular events were 25.3 %, 42.7 % and 56.5 %, respectively. Four patients were lost to follow-up. Based on a Cox model, the cumulative 3-year relative risk of death or cardiovascular event was inversely correlated to the initial WLR (RR 2.5 if WLR <0.36, 2.1 if <0.3, 4.9 if <0.27), age over 80 years (RR 1.9), and sedentarity (RR 2.3). Metabolic factors were not predictive of event-free survival.

Conclusions

In patients with end-stage CKD, a lower WLR is associated with a higher morbidity and mortality rate at 3 years. Retinal vascular metrics may therefore provide novel biomarkers for the prediction of event-free survival in CKD. Additional studies are necessary to elucidate the underlying relationship.

查看原文本刊更多论文

终末期慢性肾病患者视网膜动脉壁腔比的预后价值

目的探讨终末期慢性肾病（CKD）患者视网膜动脉壁腔比（wall-to-lumen ratio， WLR）预测发病率和死亡率的假设。方法前瞻性单中心临床研究。83例CKD患者（平均年龄（±SD） 75.8（±11.4）岁），采用自适应光学检眼镜测量视网膜血管动脉指标（AOO; rtx1, ImagineEyes, France）。进行多变量分析，包括血管指标和生物学参数，以确定3年发病率和死亡率的预测危险因素。结果纳入时，平均（±SD）壁流明比（WLR）为0.34（±0.17）。血压与WLR之间没有相关性。1年、2年、3年生存率分别为74.7%、57.3%、42.1%。1年、2年和3年非致死性心血管事件发生率分别为25.3%、42.7%和56.5%。4例患者失访。基于Cox模型，累积3年死亡或心血管事件相对风险与初始WLR （WLR = 0.36, RR = 2.5; WLR = 2.1; WLR = 0.3, RR = 4.9）、80岁以上年龄（RR = 1.9）和久坐（RR = 2.3）呈负相关。代谢因素不能预测无事件生存。结论在终末期CKD患者中，较低的WLR与较高的3年发病率和死亡率相关。因此，视网膜血管指标可能为预测CKD无事件生存提供新的生物标志物。需要进一步的研究来阐明潜在的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Microvascular research 医学-外周血管病

CiteScore

6.00

自引率

3.20%

发文量

158

审稿时长

43 days

期刊介绍： Microvascular Research is dedicated to the dissemination of fundamental information related to the microvascular field. Full-length articles presenting the results of original research and brief communications are featured. Research Areas include: • Angiogenesis • Biochemistry • Bioengineering • Biomathematics • Biophysics • Cancer • Circulatory homeostasis • Comparative physiology • Drug delivery • Neuropharmacology • Microvascular pathology • Rheology • Tissue Engineering.