Previous studies of MESA have shown that narrower CRAE or arteriolar narrowing is associated with risk of stroke,24 hypertension,23 and CKD development19 while a wider CRVE or venular widening is linked to hypertension,25 dyslipidemia, and systemic inflammation.23 We found that higher plasma and urine KIM-1 levels were associated with narrower CRAE indicating a potential shared pathway between kidney tubule injury and retinal microvascular disease, suggesting a link between the kidney tubules and systemic microvascular disease. The gene discussed is HAVCR1; the disease is metabolic syndrome.