Short-term duration of diabetic retinopathy as a predictor for development of diabetic kidney disease

Abstract

Background Diabetic retinopathy (DR) is a risk factor for diabetic kidney disease (DKD). Whether the duration, especially the short-term duration, of DR is associated with the development and progression of DKD remains unclear. Materials and Methods A retrospective study and two-sample Mendelian randomization (MR) analysis were conducted. Kidney disease was defined by the urinary albumin-to-creatinine ratio (ACR) and the estimated glomerular filtration rate (eGFR). DR was diagnosed by an expert ophthalmologist by using a digital fundus camera. Binary and ordinal logistic regression analyses were performed. A restricted cubic spline was utilized to detect nonlinear associations. Summary statistics for DR- and DKD-associated single-nuclear polymorphisms (SNPs) were extracted from the FinnGen and the UK Biobank consortia. Results A total of 2674 patients with type 2 diabetes mellitus (T2DM) and type 2 diabetic kidney disease (T2DKD) were included. The prevalence and mean duration of DR increased with elevation of ACR and decline in eGFR. Renal function was significantly reduced in patients with DR in the fifth year of life. Binary and ordinal logistic regression showed that each 1-year increase in DR duration was associated with a 19% risk increase in the development of DKD, 16% in the elevation of ACR, and 21% in the decline of renal function. MR estimates indicated that DR was causally associated with DKD development, with an odds ratio of 2.89. Conclusions DR and the duration of DR were independent risk factors for the development and progression of DKD. The short-term duration of DR may be associated with DKD development. DR had a statistically significant effect on DKD.

AKI-Pro score for predicting progression to severe acute kidney injury or death in patients with early acute kidney injury after cardiac surgery

“…Our analysis also revealed that baseline eGFR and the stage of AKI at the time of enrollment emerged as significant variables influencing the progression of AKI to stage 3 or mortality. These findings align with previous studies that have consistently demonstrated pre-existing chronic kidney disease, as indicated by reduced eGFR, to be a robust risk factor for AKI, dialysis, and mortality [ 29 – 31 ]. Furthermore, the AKI stage at enrollment appeared to reflect the severity of renal insult and exhibited a definite association with unfavorable outcomes.…”

Causal relationship between type 1 diabetes mellitus and mycoses: a Mendelian randomization study

“…Similarly, a retrospective study of deep fungal infections in elderly individuals found that diabetic patients were prone to developing invasive candidiasis, while invasive aspergillosis was less prevalent ( 4 ). Despite the established connection between diabetes and bacterial infections, the association between T1DM and mycoses remains a less explored area, presenting an intriguing path for future study ( 5 ).…”

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“…Similarly, a retrospective study of deep fungal infections in elderly individuals found that diabetic patients were prone to developing invasive candidiasis, while invasive aspergillosis was less prevalent (4). Despite the established connection between diabetes and bacterial infections, the association between T1DM and mycoses remains a less explored area, presenting an intriguing path for future study (5).…”