Introduction: Chronic kidney disease (CKD) is greatly affected by social determinants of health. Whether low educational attainment is associated with incident CKD in young adults is unclear. Methods: We evaluated the association of education with incident CKD in 3139 Coronary Artery Risk Development in Young Adults participants. We categorized education into low (high school and less), medium (college), and high (master's and professional studies) groups. Incident CKD was defined as new development of estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m 2 or urine albumin to creatinine ratio $30 mg/g. Change in eGFR over 20 years was a secondary outcome. Results: At baseline, mean age was 35.0 AE 3.6 years, 47% were Black, and 55% were women. Participants with lower educational attainment were less likely to have high income and health insurance and to engage in a healthy lifestyle. Over 20 years, 407 participants developed CKD (13%). Compared with individuals with low educational attainment, those with medium and high educational attainment had an unadjusted hazard ratios for CKD of 0.79 (95% confidence interval [CI] 0.65-0.97) and 0.44 (95% CI, 0.30-0.63), respectively. This association was no longer significant after adjusting for income, health insurance, lifestyle, and health status. Low educational attainment was significantly associated with a change in eGFR in crude and adjusted analyses, although the association was attenuated in the multivariable models (low:-0.83 [95% CI,-0.91 to-0.75], medium:-0.80 (95% CI,-0.95 to-0.64), and high:-0.70 (95% CI,-0.89 to-0.52) ml/min per 1.73 m 2 per yr). Conclusions: Health care access, lifestyle, and comorbid conditions likely help explain the association between low educational attainment and incident CKD in young adults.
Background: To evaluate the longitudinal changes on optical coherence tomography angiography (OCTA) in retinal vein occlusion (RVO). Methods: Retrospective study of patients with RVO treated with intravitreal anti-vascular endothelial growth factors (VEGF) for macular edema. Foveal avascular zone (FAZ) area, vessel density (VD), vessel length density (VLD), and adjusted flow index (AFI) were calculated. The unaffected eye of each participant was used as a control. Results: Twelve RVO eyes were included, receiving 6 ± 3 anti-VEGF injections over a follow-up of 10.4 ± 3.1 months. Compared to fellow eyes, RVO eyes had lower VD and VLD at inclusion (p = 0.07 and p = 0.04) and last visit (p = 0.002 and p < 0.001). VD, AFI, and VLD did not change over time, while FAZ area increased in RVO eyes (+0.016 ± 0.024 mm2, p = 0.04). AFI correlated with duration of disease (r = 0.63, p = 0.02). Visual acuity was inversely related to VD and VLD over the follow-up. Conclusions: OCTA parameters remained stable with sustained anti-VEGF treatment in RVO, while changes in the FAZ area may suggest capillary remodeling after RVO.
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