Diabetic retinopathy in patients with chronic kidney disease (CKD) is associated with an increased risk of CKD progression, according to a new study.
“Routine follow-up and management of ocular and retinal disorders in CKD patients with diabetes would be important for aggressive management of diabetic retinopathy and prevention of CKD progression among these patients,” Hsin-Ting Lin, MD, of Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, and colleagues reported in Nutrients.
The study included 4050 patients with diabetes and CKD aged 20 to 85 years. Of these patients, 1481 had diabetic retinopathy (518 with proliferative and 963 with non-proliferative disease) and 2569 did not. The investigators defined CKD progression as an average decrease in estimated glomerular filtration rate (eGFR) by more than 5 mL/min/1.73 m2 per year.
In a fully adjusted multivariate model, patients with diabetic retinopathy had significant 37% increased odds of CKD progression compared with those who did not have the condition. Among patients with stage 3b-5 CKD, diabetic retinopathy was associated with significant 47% increased odds of CKD progression. In addition, patients with proliferative diabetic retinopathy had significant 82% increased odds of CKD progression compared with those who had non-proliferative diabetic retinopathy.
For the study, the investigators analyzed data from the National Health Insurance Research Database and the Epidemiology and Risk Factors Surveillance of the CKD project (2008–2013). Compared with patients who did not have diabetic retinopathy, those who did had significantly lower mean baseline eGFR (39.17 vs 54.38 mL/min/1.73 m2), higher mean HbA1c values (7.85 vs 7.29), and higher mean urine protein-to-creatinine ratio (1.94 vs 0.91 g/dL).
Lin HT, Zheng CM, WuYC, et al. Diabetic retinopathy as a risk factor for chronic kidney disease progression: A multicenter case-control study in Taiwan. Nutrients. Published online ahead of print.