Diabetic retinopathy and renal function in Chinese type 2 diabetic patients
- 268 Downloads
To evaluate associations of diabetic retinopathy (DR) with renal function in Chinese type 2 diabetic patients.
This cross-sectional study enrolled 523 type 2 diabetic patients. All patients underwent ophthalmic examination to assess DR [normal, non-proliferative DR (NPDR), proliferative DR (PDR)]. The renal function measurements were taken in urine and blood. The estimated glomerular rate (eGFR) and albumin/creatinine ratio (ACR) were calculated using standard formulas. The chronic kidney disease (CKD) was defined as eGFR < 60 mL/min/1.73 m2, and microalbuminuria was defined as ACR > 17 for males and ACR > 25 for females. The associations of DR with renal function and CKD were assessed by regression models, without and with the adjustment of risk factors for CKD.
In multivariate analysis, increasing severity of DR was significantly associated with lower eGFR (p < 0.001), higher level of retinol-binding protein (p < 0.001), and larger ACR (p < 0.0001). The DR was significantly associated increased risk of CKD with odds ratio of 2.22 (95 % CI 1.01–4.86) for NPDR and 3.52 (1.30–9.55) for PDR.
Among Chinese type 2 diabetic patients, increasing DR severity is significantly associated reduced kidney function and increased risk of CKD. These associations are independent of risk factors for CKD, suggesting that assessment of DR may provide useful information on the renal function and risk of kidney disease.
KeywordsDiabetic retinopathy Renal function Chronic kidney disease
This study was partially supported by Zhejiang Province Technology Application Research Planning Grant 2011C33029 and Zhejiang Provincial Natural Science Foundation of China (Y13B020006).
Conflict of interest
- 10.Penno G, Solini A, Zoppini G, Orsi E, Zerbini G, Trevisan R, Gruden G, Cavalot F, Laviola L, Morano S, Nicolucci A, Pugliese G, Renal Insufficiency and Cardiovascular Events (RIACE) Study Group (2012) Rate and determinants of association between advanced retinopathy and chronic kidney disease in patients with type 2 diabetes: the renal insufficiency and cardiovascular events (RIACE) Italian multicenter study. Diabetes Care 35:2317–2323PubMedCentralPubMedCrossRefGoogle Scholar
- 13.National Health and Medical Research Council of Australia (1997) Management of diabetic retinopathy; Clinical Practice Guidelines 1–94Google Scholar
- 16.National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266Google Scholar
- 21.Molitch ME, Steffes M, Sun W, Epidemiology of Diabetes Interventions and Complications Study Group et al (2010) Development and progression of renal insufficiency with and without albuminuria in adults with type 1 diabetes in the diabetes control and complications trial and the epidemiology of diabetes interventions and complications study. Diabetes Care 33:1536–1543PubMedCentralPubMedCrossRefGoogle Scholar