- Baseline severity of diabetic retinopathy (DR) predicts excess risk for progression of chronic kidney disease (CKD) among patients with type 2 diabetes (T2D).
Why this matters
- Renal function and albuminuria should be closely monitored in patients with severe retinopathy.
- Korean study of 1592 patients with T2D (mean age, 57.9±11.2 years) with baseline fundus exam and serial renal measurements.
- 24.1% had nonproliferative DR (NPDR) and 12.7% had proliferative DR (PDR).
- Mean follow-up, 5.6±2.1 years.
- Funding: None.
- Patients with baseline DR had longer T2D duration and lower BMI, plasma hemoglobin, serum albumin, diabetic control, and estimated glomerular filtration rate (in mL/minute/1.73 m2) than those without (all P<.001>
- CKD progression was highest with PDR (49.5%) and NPDR (29.9%) vs no-DR (9.5%).
- Baseline DR severity was tied to greater annual decline in renal function vs no-DR at all CKD stages (NPDR and PDR vs no-DR, all P<.001 style="list-style-type:circle;">
- Stage I: −3.2±6.44 and −4.16±5.43 vs −0.83±3.48;
- Stage II: −1.91±5.71 and −3.97±6.08 vs 0.47±3.22;
- Stage IIIa: −0.53±4.25 and −2.58±5.71 vs 1.24±3.91; and
- Stage IIIb: −2.3±3.34 and −2.89±9.19 vs 0.5±4.34.
- 2.9-fold with NPDR (P<.001>
- 16.6-fold with PDR (P=.004).
- Retrospective, monocentric design.