Chronic Kidney Disease and Diabetic Retinopathy in Patients with Type 2 Diabetes

Abstract

PurposeTo explore the relationship between chronic kidney disease (CKD) and diabetic retinopathy (DR) in a representative population of type 2 diabetes mellitus (DM2) patients in Catalonia (Spain).MethodsThis was a population-based, cross-sectional study. A total of 28,344 patients diagnosed with DM2 who had recorded ophthalmologic and renal functional examinations were evaluated. Data were obtained from a primary healthcare electronic database of medical records. CKD was defined as an estimated glomerular filtration ratio (eGFR) of <60 ml/min/1.73m2 and/or urine albumin to creatinine ratio (UACR) ≥30 mg/g. DR was categorized as non-vision threatening diabetic retinopathy and vision threatening diabetic retinopathy.ResultsCKD was associated with a higher rate of DR [OR], 95% confidence interval [CI], 1.5 (1.4–1.7). When we analyzed the association between different levels of UACR and DR prevalence observed that DR prevalence rose with the increase of UACR levels, and this association was significant from UACR values ≥10 mg/g, and increased considerably with UACR values ≥300mg/g (Odds ratio [OR], 95% confidence interval [CI], 2.0 (1.6–2.5). This association was lower in patients with eGFR levels 44 to 30 mL/min/1.73m2 [OR], 95% confidence interval [CI], 1.3 (1.1–1.6).ConclusionsThese results show that CKD, high UACR and/or low eGFR, appear to be associated with DR in this DM2 population.

Associations between diabetic retinopathy and systemic risk factors

“…[4][5][6][7][8]10,19,21,22,24,28,30,34,[38][39][40][42][43][44][47][48][49][50][51][52][53] 69 This is consistent with other genome-wide association studies in Caucasian and Mexican-American patients. 70,71 As the relationship between genetic polymorphisms and diabetic retinopathy is still a new and emerging field, some studies have demonstrated new associations between single nucleotide polymorphisms, but these studies have not yet been replicable.…”

“…48 These findings were corroborated by Penno et al 49 who reported that a high urine albumin-to-creatinine ratio of ≥300 mg/g was associated with diabetic retinopathy (OR=2.9; 95% CI, 2.1-4.0). Likewise, Rodríguez-Poncelas et al 50 found that increasing urine albumin-to-creatinine ratio was significantly correlated with rising diabetic retinopathy prevalence, and this association was significant even at urine albumin-to-creatinine levels of ≥10 mg/g (OR=1.2; 95% CI, 1.1-1.4).…”

Association of Abnormal Renal Profiles and Proliferative Diabetic Retinopathy and Diabetic Macular Edema in an Asian Population With Type 2 Diabetes

“…It is characterized by increased serum creatinine levels, persistent albuminuria, and decreased glomerular filtration rates. Previous studies have shown that albuminuria and a low estimated glomerular filtration rate (eGFR) were both risk factors for DR. [3][4][5][6][7] However, most previous studies were cross-sectional, not longitudinal. As for DME, only limited studies have reported its association with renal function.…”

Detection of Lower Albuminuria Levels and Early Development of Diabetic Kidney Disease Using an Artificial Intelligence-Based Rule Extraction Approach

“…To date, many studies have reported UACR cut-off values for diseases that are associated with diabetic diabetes, e.g., MA cut-offs of 19.25 mg/g Cr [19] for hypertension; 10.7 mg/g Cr [20], 15.6 mg/g Cr [21], 10.7 mg/g Cr [22], and 10.0 mg/g Cr [23] for diabetic retinopathy (DR); and 4.8 mg/g Cr [6] for metabolic syndrome. However, only four studies that investigated the cut-off values for type 2 diabetes [15], CKD [16], and DN [17,18] have been conducted.…”