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논문분류	춘계학술대회 초록집
제목	The Impact of Retinopathy on CKD Progression and Cardiovascular Events in Patients with Chronic Kidney Disease
저자	Se Young Kim1, Hye Eun Yoon1, Yoo A Choi1, Won-kyung Cho2, Yoon Kyung Chang1,Chul Woo Yang1, Suk Young Kim1, Hyeon Seok Hwang1, Ae Ja Oh1
출판정보	2014; 2014(1):
키워드	만성신질환, 망막병증, 심혈관질환
초록	Background: Chronic kidney disease (CKD) and retinopathy shares a common pathophysiology of microvascular dysfunction, and retinopathy is prevalent disorder in CKD patients. However, the clinical impacts of retinopathy on CKD patients are undetermined. Methods: We included 692 patients, who had nondialysis-dependent CKD stages 3-5. The clinical significance of retinopathy was evaluated with rate of renal function decline and composite of any cardiovascular event or patient death after index retinopathy examination. Results: The retinopathy was observed in 313 (45.2%) CKD patients. Of these, 261 (37.7%) patients had diabetic retinopathy and hypertensive retinopathy was found in 52 (7.5%) patients. The rate of renal function decline was significantly steeper in CKD patients with retinopathy than those without retinopathy (-6.64±9.67 mL/min/1.73m2/y vs. -3.00±9.37 mL/min/1.73m2/y; p<0.001). The patients with proliferative diabetic retinoapthy showed more rapid renal function decline than patients with non-proliferative diabetic retinoapthy or patients with hypertensive retinopathy (all p<0.05). In a multivariate analysis, retinopathy was an independent predictor for renal function decline (beta=-2.31; p=0.007). The patients with retinopathy showed lower composite event-free survival rate than those without retinopathy (p=0.020). In the multivariate Cox hazards model, the retinopathy was independently associated with any cardiovascular events or death (hazard ratio, 1.53; 95% confidence interval 1.03-2.28; p=0.037). Conclusions: The retinopathy is an independent risk factor for rapid renal function decline and predicts a higher rate of cardiovascular event or death in patients with CKD. These findings allow for the identification of individuals at greatest risk for major complication of CKD.
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