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SHR Neuro Krebs Kardio Lipid

Günthner, R; Hanssen, H; Hauser, C; Angermann, S; Lorenz, G; Kemmner, S; Matschkal, J; Braunisch, MC; Kuechle, C; Renders, L; Moog, P; Wassertheurer, S; Baumann, M; Hammes, HP; Mayer, CC; Haller, B; Stryeck, S; Madl, T; Carbajo-Lozoya, J; Heemann, U; Kotliar, K; Schmaderer, C.
Impaired Retinal Vessel Dilation Predicts Mortality in End-Stage Renal Disease.
Circ Res. 2019; [OPEN ACCESS]
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Madl Tobias
Stryeck Sarah
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Abstract:
Patients with end-stage renal disease (ESRD) are characterized by increased cardiovascular (CV) and all-cause mortality due to advanced remodeling of the macro- and microvascular beds. The aim of this study was to determine whether retinal microvascular function can predict all-cause and CV mortality in patients with ESRD. In the multicenter prospective observational ISAR (Risk Stratification in End-Stage Renal Disease) study, data on dynamic retinal vessel analysis (DVA) was available in a sub-cohort of 214 dialysis patients (mean age 62.6{plus minus}15.0; 32% female). Microvascular dysfunction was quantified by measuring maximum arteriolar (aMax) and venular dilation (vMax) of retinal vessels in response to flicker light stimulation. During a mean follow-up of 44 months, 55 patients died, including 25 CV and 30 non-CV fatal events. vMax emerged as a strong independent predictor for all-cause mortality. In the Kaplan-Meier analysis, individuals within the lowest tertile of vMax showed significantly shorter three-year survival rates than those within the highest tertile (66.9{plus minus}5.8% vs 92.4{plus minus}3.3%). Uni- and multivariate hazard ratios for all-cause mortality per SD increase of vMax were 0.62 [0.47;0.82] and 0.65[0.47;0.91], respectively. aMax and vMax were able to significantly predict nonfatal and fatal CV events (HR 0.74[0.57;0.97] and 0.78[0.61;0.99], respectively). Our results provide the first evidence that impaired retinal venular dilation is a strong and independent predictor of all-cause mortality in hemodialyzed ESRD patients. DVA provides added value for prediction of all-cause mortality and may be a novel diagnostic tool to optimize CV risk stratification in ESRD and other high-risk CV cohorts. NCT01152892.

Find related publications in this database (Keywords)
dialysis
humans
microcirculation
renal insufficiency
retinal vessels
venules
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