Prevalence and Determinants of Hypertensive Retinopathy Ii Nondiabetic CKD Patients

Background: Hypertensive retinopathy is a common microvascular complication of chronic hypertension and may reflect systemic vascular damage in patients with chronic kidney disease (CKD). In Bihar region the prevalence and determinants of hypertensive retinopathy among nondiabetic CKD patients remain scarce, despite the high burden of both hypertension and renal impairment. Aim: To determine the prevalence of hypertensive retinopathy and identify its associated clinical and laboratory factors among nondiabetic CKD patients at Department of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India for one year Methods: In this cross‐sectional study, 120 adult nondiabetic CKD patients (mean age 54.2 ± 11.6 years; 68 males) were consecutively enrolled from the nephrology clinic at Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India for one year. CKD staging was based on eGFR calculated using the CKD‐EPI equation: stages 1–2 (n = 35), stage 3 (n = 40), and stages 4–5 (n = 45). All participants underwent dilated fundus examination by a retina specialist, with retinopathy graded according to the Keith–Wagener–Barker classification. Clinical data collected included duration of hypertension, systolic and diastolic blood pressure (mean of two readings), and body mass index; laboratory parameters included serum creatinine, hemoglobin, and uric acid. Associations with any hypertensive retinopathy were assessed using chi‐square tests and multivariable logistic regression. Results: Hypertensive retinopathy was detected in 72/120 patients (60.0%). Prevalence by CKD stage was 34.3% in stages 1–2, 62.5% in stage 3, and 75.6% in stages 4–5 (chi‐square for trend = 18.7; p < 0.001). In multivariable analysis, independent predictors of retinopathy were systolic blood pressure ≥160 mm Hg (OR 2.75; 95% CI 1.405.42; p = 0.003), CKD stage 4–5 versus stages 1–2 (OR 3.10; 95% CI 1.45–6.64; p = 0.004), and serum uric acid >7 mg/dL (OR 1.95; 95% CI 1.02–3.74; p = 0.043). Conclusion: Hypertensive retinopathy is highly prevalent among nondiabetic CKD patients, with greater odds in those with advanced CKD, poorly controlled systolic hypertension, and elevated uric acid. Routine fundus examination should be incorporated into CKD care to identify patients at risk of systemic microvascular complications and guide optimized blood‐pressure management.