Pulse-Wave Analysis of Optic Nerve Head Circulation Is Significantly Correlated with Kidney Function in Patients with and without Chronic Kidney Disease
Aim. To determine whether there is a significant correlation between the optic nerve head (ONH) circulation determined by laser speckle flowgraphy (LSFG) and kidney function. Materials. Seventy-one subjects were investigated. The estimated glomerular filtration rate (GFR) and serum creatinine, cystatin C, and urinary albumin excretion were measured. The ONH circulation was determined by an analysis of the pulse wave of LSFG, and this parameter was named blowout time (BOT). Chronic kidney disease (CKD) was defined to be present when the estimated GFR was <60？mL/min per 1.73？m2. Pearson’s correlation coefficients were used to determine the relationship between the BOT and the kidney function. We also examined whether there were significant differences in all parameters in patients with and without CKD. Results. BOT was significantly correlated with the level of creatinine ( , ), the estimated GFR ( , ), cystatin C ( , ), and urinary albumin excretion ( , ). The BOT level in subjects with CKD was significantly lower than that in subjects without CKD ( ). Conclusion. BOT in ONH by LSFG can detect the organ damage such as kidney dysfunction, CKD. 1. Introduction Chronic kidney disease (CKD) is associated with high cardiovascular mortality [1–3]. More than 45% of predialysis CKD patients die with cardiovascular disease before reaching the end stage of kidney disease [4]. CKD has been defined as a creatinine-based estimated glomerular filtration rate (GFR) that is <60？mL/min per 1.73？m2 [5]. This represents a loss of more than one-half of normal renal function. An estimated GFR of <60？mL/min per 1.73？m2 has been strongly correlated with cardiovascular risk and death [3]. Other factors reflecting kidney function are the levels of serum cystatin C and urinary albumin excretion. Evaluations of serum cystatin C and serum creatinine were reported to predict cardiovascular events in elderly persons without chronic kidney disease [6]. In addition, urinary albumin excretion is a predictor of all causes of mortality in the general population [7]. However, the relationship between these kidney function parameters and ocular circulation remains unclear. Therefore, it was suggested that evaluations of the relationships between ocular circulation and kidney function are important, because kidney and eye reflect the peripheral circulation in both. Laser speckle flowgraphy (LSFG; Kyushu Institute of Technology, Fukuoka, Japan) is a method of determining ocular blood flow and is based on the changes in the speckle pattern of laser light reflected from the fundus of the eye
References
[1]
B. F. Culleton, M. G. Larson, P. W. F. Wilson, J. C. Evans, P. S. Parfrey, and D. Levy, “Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency,” Kidney International, vol. 56, no. 6, pp. 2214–2219, 1999.
[2]
A. X. Garg, W. F. Clark, R. B. Haynes, and A. A. House, “Moderate renal insufficiency and the risk of cardiovascular mortality: results from the NHANES I,” Kidney International, vol. 61, no. 4, pp. 1486–1494, 2002.
[3]
A. S. Go, G. M. Chertow, D. Fan, C. E. McCulloch, and C.-Y. Hsu, “Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization,” The New England Journal of Medicine, vol. 351, no. 13, pp. 1296–1305, 2004.
[4]
D. S. Keith, G. A. Nichols, C. M. Gullion, J. B. Brown, and D. H. Smith, “Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization,” Archives of Internal Medicine, vol. 164, no. 6, pp. 659–663, 2004.
[5]
A. S. Levey, K.-U. Eckardt, Y. Tsukamoto et al., “Definition and classification of chronic kidney disease: a position statement from kidney disease: improving global outcomes (KDIGO),” Kidney International, vol. 67, no. 6, pp. 2089–2100, 2005.
[6]
M. G. Shlipak, R. Katz, M. J. Sarnak et al., “Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease,” Annals of Internal Medicine, vol. 145, no. 4, pp. 237–246, 2006.
[7]
H. L. Hillege, V. Fidler, G. F. H. Diercks et al., “Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population,” Circulation, vol. 106, no. 14, pp. 1777–1782, 2002.
[8]
Y. Tamaki, M. Araie, E. Kawamoto, S. Eguchi, and H. Fujii, “Non-contact, two-dimensional measurement of tissue circulation in choroid and optic nerve head using laser speckle phenomenon,” Experimental Eye Research, vol. 60, no. 4, pp. 373–383, 1995.
[9]
H. Isono, S. Kishi, Y. Kimura, N. Hagiwara, N. Konishi, and H. Fujii, “Observation of choroidal circulation using index of erythrocytic velocity,” Archives of Ophthalmology, vol. 121, no. 2, pp. 225–231, 2003.
[10]
H. Fujii, “Visualisation of retinal blood flow by laser speckle flowgraphy,” Medical and Biological Engineering and Computing, vol. 32, no. 3, pp. 302–304, 1994.
[11]
S. Matsuo, E. Imai, M. Horio et al., “Revised equations for estimated GFR from serum creatinine in Japan,” American Journal of Kidney Diseases, vol. 53, no. 6, pp. 982–992, 2009.
[12]
A. D. Rule and B. W. Teo, “GFR estimation in Japan and China: what accounts for the difference?” American Journal of Kidney Diseases, vol. 53, no. 6, pp. 932–935, 2009.
[13]
T. Sugiyama, M. Araie, C. E. Riva, L. Schmetterer, and S. Orgul, “Use of laser speckle flowgraphy in ocular blood flow research,” Acta Ophthalmologica, vol. 88, no. 7, pp. 723–729, 2010.
[14]
T. Shiba, M. Takahashi, Y. Hori, and T. Maeno, “Pulse-wave analysis of optic nerve head circulation is significantly correlated with brachial-ankle pulse-wave velocity, carotid intima-media thickness, and age,” Graefe's Archive for Clinical and Experimental Ophthalmology, vol. 250, no. 9, pp. 1275–1281, 2012.
[15]
T. Shiba, M. Takahashi, Y. Hori, T. Maeno, and K. Shirai, “Optic nerve head circulation determined by pulse wave analysis is significantly correlated with cardio ankle vascular index, left ventricular diastolic function, and age,” Journal of Atherosclerosis and Thrombosis, vol. 19, no. 11, pp. 999–1005, 2012.
[16]
Y. Ohya, K. Iseki, C. Iseki, T. Miyagi, K. Kinjo, and S. Takishita, “Increased pulse wave velocity is associated with low creatinine clearance and proteinuria in a screened cohort,” American Journal of Kidney Diseases, vol. 47, no. 5, pp. 790–797, 2006.
[17]
G. Schillaci, M. Pirro, M. R. Mannarino et al., “Relation between renal function within the normal range and central and peripheral arterial stiffness in hypertension,” Hypertension, vol. 48, no. 4, pp. 616–621, 2006.
[18]
E. Kimoto, T. Shoji, K. Shinohara et al., “Regional arterial stiffness in patients with type 2 diabetes and chronic kidney disease,” Journal of the American Society of Nephrology, vol. 17, no. 8, pp. 2245–2252, 2006.
[19]
J.-J. Mourad, B. Pannier, J. Blacher et al., “Creatinine clearance, pulse wave velocity, carotid compliance and essential hypertension,” Kidney International, vol. 59, no. 5, pp. 1834–1841, 2001.
[20]
M. Briet, E. Bozec, S. Laurent et al., “Arterial stiffness and enlargement in mild-to-moderate chronic kidney disease,” Kidney International, vol. 69, no. 2, pp. 350–357, 2006.
[21]
M.-C. Wang, W.-C. Tsai, J.-Y. Chen, and J.-J. Huang, “Stepwise increase in arterial stiffness corresponding with the stages of chronic kidney disease,” American Journal of Kidney Diseases, vol. 45, no. 3, pp. 494–501, 2005.
[22]
S. Hanada, R. Ando, S. Naito et al., “Assessment and significance of abdominal aortic calcification in chronic kidney disease,” Nephrology Dialysis Transplantation, vol. 25, no. 6, pp. 1888–1895, 2010.
[23]
T. Nagaoka and A. Yoshida, “Relationship between retinal blood flow and renal function in patients with type 2 diabetes and chronic kidney disease,” Diabetes Care, vol. 36, pp. 957–961, 2013.
[24]
E. Imai, M. Horio, T. Watanabe et al., “Prevalence of chronic kidney disease in the Japanese general population,” Clinical and experimental nephrology, vol. 13, no. 6, pp. 621–630, 2009.
[25]
M. J. Klag, P. K. Whelton, B. L. Randall et al., “Blood pressure and end-stage renal disease in men,” The New England Journal of Medicine, vol. 334, no. 1, pp. 13–18, 1996.
