@article {8628,
	title = {A systematic review and participant-level meta-analysis found little association of retinal microvascular caliber and reduced kidney function.},
	journal = {Kidney Int},
	year = {2020},
	month = {2020 Aug 15},
	abstract = {<p>Previously, variation in retinal vascular caliber has been reported in association with chronic kidney disease (CKD) but findings remain inconsistent. To help clarify this we conducted individual participant data meta-analysis and aggregate data meta-analysis on summary estimates to evaluate cross-sectional associations between retinal vascular caliber and CKD. A systematic review was performed using Medline and EMBASE for articles published until October 2018. The aggregate analysis used a two-stage approach combining summary estimates from eleven studies (44,803 patients) while the individual participant analysis used a one-stage approach combining raw data from nine studies (33,222 patients). CKD stages 3-5 was defined as an estimated glomerular filtration rate under 60 mL/min/1.73m. Retinal arteriolar and venular caliber (central retinal arteriolar and venular equivalent) were assessed from retinal photographs using computer-assisted methods. Logistic regression estimated relative risk of CKD stages 3-5 associated with a 20 μm decrease (approximately one standard deviation) in central retinal arteriolar and venular equivalent. Prevalence of CKD stages 3-5 was 11.2 \% of 33,222 and 11.3 \% of 44,803 patients in the individual participant and aggregate data analysis, respectively. No significant associations were detected in adjusted analyses between central retinal arteriolar and venular equivalent and CKD stages 3-5 in the aggregate analysis for central retinal arteriolar relative risk (0.98, 95\% confidence interval 0.94-1.03); venular equivalent (0.99, 0.95- 1.04) or individual participant central retinal arteriolar (0.99, 0.95-1.04) or venular equivalent (1.01, 0.97-1.05). Thus, meta-analysis provided little evidence to suggest that cross sectional direct measurements of retinal vascular caliber was associated with CKD stages 3-5 in the general population. Hence, meta-analyses of longitudinal studies evaluating the association between retinal parameters and CKD stages 3-5 may be warranted.</p>},
	issn = {1523-1755},
	doi = {10.1016/j.kint.2020.06.033},
	author = {Lye, Weng Kit and Paterson, Euan and Patterson, Christopher C and Maxwell, Alexander P and Binte Mohammed Abdul, Riswana Banu and Tai, E Shyong and Cheng, Ching Yu and Kayama, Takamasa and Yamashita, Hidetoshi and Sarnak, Mark and Shlipak, Michael and Matsushita, Kunihiro and Mutlu, Unal and Ikram, Mohammad A and Klaver, Caroline and Kifley, Annette and Mitchell, Paul and Myers, Chelsea and Klein, Barbara E and Klein, Ronald and Wong, Tien Y and Sabanayagam, Charumathi and McKay, Gareth J}
}
