Original InvestigationPathogenesis and Treatment of Kidney DiseaseRetinopathy and CKD as Predictors of All-Cause and Cardiovascular Mortality: National Health and Nutrition Examination Survey (NHANES) 1988-1994
Section snippets
Study Population and Baseline Data
NHANES III was conducted by the National Center for Health Statistics (NCHS) between 1988 and 1994 using a stratified clustered multistage probability sample survey design of the civilian noninstitutionalized US population with oversampling of blacks and Mexican Americans. The survey protocol was approved by the NCHS institutional review board. All participants provided informed consent.
There were 9,239 participants 40 years or older who were interviewed at home for sociodemographic and medical
Participant Characteristics
The overall weighted prevalence of retinopathy was 4.6%. The weighted prevalence of retinopathy was 11.0% for participants with CKD (25% and 6% in those with and without diabetes, respectively) and 3.7% in individuals without CKD. The weighted prevalence of CKD was 15%. Demographic and clinical characteristics of participants overall and by CKD and retinopathy status are presented in Table 1. Mean age was 56 years, 53% of participants were women, and 81% were non-Hispanic whites. Among
Discussion
Although previous studies have examined the association of retinopathy and mortality in non-CKD populations, to our knowledge, this study is the first to examine the joint effect of retinopathy and CKD on mortality. Compared with individuals with neither retinopathy nor CKD, the presence of both retinopathy and CKD was associated with a more than 2-fold increase in all-cause and cardiovascular mortality independent of demographic and clinical factors, including smoking, hypertension, and
Acknowledgements
Support: Dr Ricardo is funded by grant 1K23DK094829-01 from the National Institute of Diabetes and Digestive and Kidney Diseases.
Financial Disclosure: The authors declare that they have no other relevant financial interests.
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2016, OphthalmologyCitation Excerpt :Increased cardiovascular mortality risk (over a 14-year follow-up period) was independently associated with mild hypertensive retinopathy among men and women with and without hypertension in the Ibaraki Prefectural Health Study.13 However, it is well known that CVD and retinopathy are complications of diabetes,30–32 and multiple studies have considered the impact of retinopathy on mortality risk, particularly resulting from CVD, in persons with diabetes.14–17,33 Proliferative retinopathy predicted all-cause, CVD, and congenital heart disease death in Finnish men and women, aged 45 to 64 years, with diabetes mellitus who were free of CVD at baseline, even after adjustment for traditional CVD risk factors, glycemic control, duration of diabetes, and proteinuria.14