Journal Article

Fractal analysis of the retinal vasculature and chronic kidney disease

Chelvin C.A. Sng, Charumathi Sabanayagam, Ecosse L. Lamoureux, Erica Liu, Su Chi Lim, Haslina Hamzah, Jeannette Lee, E. Shyong Tai and Tien Y. Wong

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 25, issue 7, pages 2252-2258
Published in print July 2010 | ISSN: 0931-0509
Published online February 2010 | e-ISSN: 1460-2385 | DOI:
Fractal analysis of the retinal vasculature and chronic kidney disease

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Background. Fractal analysis provides a global index of the geometric complexity and optimality of vascular networks. In this study, we investigated the relationship between fractal measurements of the retinal vasculature and chronic kidney disease (CKD).

Methods. This was a population-based case-control study which included participants from the Singapore Prospective Study Program. We identified 261 participants with CKD, defined as estimated glomerular filtration rate of <60 mL/min/1.73 m2, and 651 controls. The retinal fractal dimension (Df) was quantified from digitized fundus photographs using a computer-based programme.

Results. The mean Df was 1.43 ± 0.048 in the participants with CKD and 1.44 ± 0.042 in controls (P = 0.013). Suboptimal Df in the lowest (first) and highest (fifth) quintiles were associated with an increased prevalence of CKD after adjusting for age, systolic blood pressure, diabetes and other risk factors [odds ratio (OR) 2.10, 95% confidence interval (CI) 1.15, 3.83 and OR 1.84, 95% CI 1.06, 3.17; compared to the fourth quintile, respectively). This association was present even in participants without diabetes or hypertension.

Conclusions. Our study found that an abnormal retinal vascular network is associated with an increased risk of CKD, supporting the hypothesis that deviations from optimal microvascular architecture may be related to kidney damage.

Keywords: chronic kidney disease; retinal vascular network

Journal Article.  4383 words.  Illustrated.

Subjects: Nephrology

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