- Diabetic retinopathy presence and severity are tied to an increased risk for chronic kidney disease (CKD) progression.
Why this matters
- Findings warrant prevention, early detection, and aggressive management of retinopathy in patients with comorbid diabetes and CKD.
- Multicenter longitudinal study of 4050 diabetic patients with CKD aged 20-85 (mean, ~65.5) years, from the Taiwanese Epidemiology and Risk Factors Surveillance of the CKD project and the National Health Insurance Research Database.
- 1481 (36.6%) had diabetic retinopathy; 518 patients (35.0%) were proliferative.
- CKD progression defined as estimated glomerular filtration rate (eGFR, in mL/minute/1.73 m2) decrease >5 per year.
- Funding: Taiwanese Ministry of Health and Welfare.
- CKD patients with vs without diabetic retinopathy had:
- Lower baseline eGFR: 39.17±30.36 vs 54.38±33.67.
- Higher HbA1c: 7.85%±4.97% vs 7.29%±4.02%.
- Higher urine protein-to-creatinine ratio (UPCR): 1.94±2.96 vs 0.91±2.11 g/dL.
- More anemia: hemoglobin, 11.22±2.43 vs 12.39±3.85 g/dL.
- More hypoalbuminemia: 3.88±0.95 vs 4.16±1.74 g/dL.
- More CKD progression events: 21.67% vs 13.62% (all P<.01>
- In multivariate analysis, diabetic retinopathy was tied to 37% higher odds of CKD progression (OR=1.37; P<.05>
- Risk was exacerbated in a subset of patients with stage IIIb-IV CKD (OR=1.47; P<.05>
- Risk was higher with proliferative vs nonproliferative retinopathy (OR=1.82; P<.05>
- Incident CKD not captured.