03249nas a2200385   4500008004100000022001400041245014700055210006900202260001600271520204100287100001902328700001902347700003002366700002602396700003102422700001902453700002102472700002102493700002502514700001702539700002102556700002502577700001602602700002302618700002102641700002002662700001902682700001902701700002202720700001802742700001802760700002802778700002102806856003602827       2020                        eng d  a1523-175500aA systematic review and participant-level meta-analysis found little association of retinal microvascular caliber and reduced kidney function.0 asystematic review and participantlevel metaanalysis found little  c2020 Aug 153 a<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>1 aLye, Weng, Kit1 aPaterson, Euan1 aPatterson, Christopher, C1 aMaxwell, Alexander, P1 aAbdul, Riswana, Banu Binte1 aTai, Shyong, E1 aCheng, Ching, Yu1 aKayama, Takamasa1 aYamashita, Hidetoshi1 aSarnak, Mark1 aShlipak, Michael1 aMatsushita, Kunihiro1 aMutlu, Unal1 aIkram, Mohammad, A1 aKlaver, Caroline1 aKifley, Annette1 aMitchell, Paul1 aMyers, Chelsea1 aKlein, Barbara, E1 aKlein, Ronald1 aWong, Tien, Y1 aSabanayagam, Charumathi1 aMcKay, Gareth, J  uhttps://chs-nhlbi.org/node/8628