JDM  Vol.6 No.2 , May 2016
The Relationship between Central Retinal Artery Resistive Index and Measures of Renal Function in Type 2 Diabetes
Abstract: Background: Renal and ocular vessels are some of the major vessels affected in patients with diabetes, and the involvement of these vessels is independent risk factors for other complications. Hemodynamic flow in arteries may be assessed by using measures such as resistive index, which is a non-invasive measure of the resistance in vessels. The association between retinopathy and nephropathy has been conflicting. This study assessed the relationship between resistive index of the central retinal artery and indices of nephropathy in type 2 diabetes. Method: This cross-sectional study examined 74 Nigerian diabetics who were selected consecutively from the out-patient diabetic clinic of a tertiary hospital in South-West Nigeria. Doppler ultrasound was used to determine the resistive index of the central retinal artery along with the right renal artery. The urinary and serum biochemical parameters were also done to determine the urinary albumin excretion and the glomerular filtration rate. Results: The mean age of participants was 59.62 ± 9.55 years. The mean central retinal artery resistive index (CRARI) was 0.77 ± 0.06, with 65 (87.8%) of the participants having elevated CRARI. There was no statistical difference between patients with normal CRARI and elevated CRARI in respect of their urinary albumin excretion (p = 0.796). There was no significant correlation between CRARI and estimated glomerular filtration rate (r = 0.120; p = 0.309) and right renal artery resistive index (r = 0.068; p = 0.564). Conclusion: This study demonstrates that central retinal artery resistive index (CRARI) may not be a predictor of renal function in diabetics.
Cite this paper: Ayoola, O. , Soyoye, D. , Dawha, S. , Ikem, R. , Onakpoya, O. , Adedeji, T. and Arogundade, F. (2016) The Relationship between Central Retinal Artery Resistive Index and Measures of Renal Function in Type 2 Diabetes. Journal of Diabetes Mellitus, 6, 146-151. doi: 10.4236/jdm.2016.62015.

[1]   James, M.T., Hemmelgarn, B.R. and Tonelli, M. (2010) Early Recognition and Prevention of Chronic Kidney Disease. The Lancet, 375, 1296-1309.

[2]   Amin, M.B., Rekha, K.P., Shegufta, F., Rahman, M.T., Abedin, N. and Mohuiddin, A.S. (2014) Resistive Index of Retinal Arterial Blood Flow in Type-II Diabetics without Retinopathy. Bangladesh Medical Journal Khulna, 47, 7-11.

[3]   Kyari, F., Tafida, A., Sivasubramaniam, S., Murthy, G.V., Peto, T. and Gilbert, C.E. (2014) Prevalence and Risk Factors for Diabetes and Diabetic Retinopathy: Results from the Nigeria National Blindness and Visual Impairment Survey. BMC Public Health, 14, 1299.

[4]   Rotimi, C., Daniel, H., Zhou, J., Obisesan, A., Chen, G. and Chen, Y. (2003) Prevalence and Determinants of Diabetic Retinopathy and Cataracts in West African Type 2 Diabetes Patients. Ethnicity and Disease, 13, S2-S110.

[5]   Tesfaye, S. and Gill, G. (2001) Chronic Diabetic Complications in Africa. The African Journal of Diabetes Medicine, 19, 37-40.

[6]   Chandy, A., Pawar, B., John, M. and Isaac, R. (2008) Association between Diabetic Nephropathy and Other Diabetic Microvascular and Macrovascular Complications. Saudi Journal of Kidney Disease and Transplantation, 19, 924.

[7]   Grunwald, J.E., Alexander, J., Ying, G.S., Maguire, M., Daniel, E., Whittock-Martin, R. and Townsend, R. (2012) Retinopathy and Chronic Kidney Disease in the Chronic Renal Insufficiency Cohort (CRIC) Study. Archives of Ophthalmology, 130, 1136-1144.

[8]   Klein, R., Zinman, B., Gardiner, R., Suissa, S., Donnelly, S.M., Sinaiko, A.R., et al. (2005) The Relationship of Diabetic Retinopathy to Preclinical Diabetic Glomerulopathy Lesions in Type 1 Diabetic Patients. The Renin-Angiotensin System Study. Diabetes, 54, 527-533.

[9]   Prakash, J., Lodha, M., Singh, S.K., Vohra, R. and Raja, R. (2007) Diabetic Retinopathy Is a Poor Predictor of Type of Nephropathy in Proteinuric Type 2 Diabetic Patients. The Journal of the Association of Physicians of India, 55, 412-416.

[10]   Basturk, T., Akcay, M., Albayrak, R., Unsal, A., Ulas, T. and Koc, Y. (2012) Correlation between the Resistive Index Values of Renal and Orbital Arteries. Kidney and Blood Pressure Research, 35, 332-339.

[11]   Polska, E., Kircher, K., Ehrlich, P., Vecsei, P.V. and Schmetterer, L. (2001) RI in Central Retinal Artery as Assessed by CDI Does Not Correspond to Retinal Vascular Resistance. American Journal of Physiology Heart and Circulatory Physiology, 280, H1442-H1447.

[12]   Hamano, K., Nitta, A., Ohtake, T. and Kobayashi, S. (2008) Associations of Renal Vascular Resistance with Albuminuria and Other Macroangiopathy in Type 2 Diabetic Patients. Diabetes Care, 31, 1853-1857.

[13]   National Kidney Foundation (2002) K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification.

[14]   Brownlee, M. (2005) The Pathobiology of Diabetic Complications: A Unifying Mechanism. Diabetes, 54, 1615-1625.

[15]   Melmed, S., Polonsky, K.S., Larsen, P.R. and Kronenberg, H.M. (2015) Williams Textbook of Endocrinology. Elsevier Health Sciences, Philadelphia.

[16]   Fong, D.S., Aiello, L.P., Gardner, T.W., King, G.L., Blankenship, G., Cavallerano, J.D. and Klein, R. (2004) Retinopathy in Diabetes. Diabetes Care, 27, S84-S87.

[17]   Arai, T., Numata, K., Tanaka, K., Kiba, T., Kawasaki, S., Saito, T. and Sekihara, H. (1998) Ocular Arterial Flow Hemodynamics in Patients with Diabetes Mellitus. Journal of Ultrasound in Medicine, 17, 675-681.

[18]   Bude, R.O. and Rubin, J.M. (1999) Relationship between the Resistive Index and Vascular Compliance and Resistance. Radiology, 211, 411-417.

[19]   Saunders, H.M., Burns, P.N., Needleman, L., Liu, J., Boston, R., Wortman, J.A. and Chan, L. (1998) Hemodynamic Factors Affecting Uterine Artery Doppler Waveform Pulsability in Sheep. Journal of Ultrasound in Medicine, 17, 357-368.

[20]   Price, C.P., Newall, R.G. and Boyd, J.C. (2005) Use of Protein: Creatinine Ratio Measurements on Random Urine Samples for Prediction of Significant Proteinuria: A Systematic Review. Clinical Chemistry, 51, 1577-1586.

[21]   Mitchell, S.C.M., Sheldon, T.A. and Shaw, A.B. (1993) Quantification of Proteinuria: A Re-Evaluation of the Protein/Creatinine Ratio for Elderly subjects. Age Ageing, 22, 443-449.