The eye, the kidney, and cardiovascular disease: old concepts, better tools, and new horizons.
chronic kidney disease
hypertension
imaging
microcirculation
ocular
proteinuria
Journal
Kidney international
ISSN: 1523-1755
Titre abrégé: Kidney Int
Pays: United States
ID NLM: 0323470
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
10
09
2019
revised:
09
01
2020
accepted:
13
01
2020
pubmed:
31
5
2020
medline:
22
6
2021
entrez:
31
5
2020
Statut:
ppublish
Résumé
Chronic kidney disease (CKD) is common, with hypertension and diabetes mellitus acting as major risk factors for its development. Cardiovascular disease is the leading cause of death worldwide and the most frequent end point of CKD. There is an urgent need for more precise methods to identify patients at risk of CKD and cardiovascular disease. Alterations in microvascular structure and function contribute to the development of hypertension, diabetes, CKD, and their associated cardiovascular disease. Homology between the eye and the kidney suggests that noninvasive imaging of the retinal vessels can detect these microvascular alterations to improve targeting of at-risk patients. Retinal vessel-derived metrics predict incident hypertension, diabetes, CKD, and cardiovascular disease and add to the current renal and cardiovascular risk stratification tools. The advent of optical coherence tomography (OCT) has transformed retinal imaging by capturing the chorioretinal microcirculation and its dependent tissue with near-histological resolution. In hypertension, diabetes, and CKD, OCT has revealed vessel remodeling and chorioretinal thinning. Clinical and preclinical OCT has linked retinal microvascular pathology to circulating and histological markers of injury in the kidney. The advent of OCT angiography allows contrast-free visualization of intraretinal capillary networks to potentially detect early incipient microvascular disease. Combining OCT's deep imaging with the analytical power of deep learning represents the next frontier in defining what the eye can reveal about the kidney and broader cardiovascular health.
Identifiants
pubmed: 32471642
pii: S0085-2538(20)30216-7
doi: 10.1016/j.kint.2020.01.039
pmc: PMC7397518
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
323-342Subventions
Organisme : Department of Health
ID : CS-2014-14-023
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/13/30/29994
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T019050/1
Pays : United Kingdom
Informations de copyright
Copyright © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
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