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. 2016 Feb 17;11(2):e0149448.
doi: 10.1371/journal.pone.0149448. eCollection 2016.

Chronic Kidney Disease and Diabetic Retinopathy in Patients with Type 2 Diabetes

Antonio Rodríguez-Poncelas  1   2   3 , Xavier Mundet-Tudurí  3   4 , Sonia Miravet-Jiménez  3   5 , Aina Casellas  2 , Joan F Barrot-De la Puente  2   6 , Josep Franch-Nadal  3   7   8 , Gabriel Coll-de Tuero  1   2
Affiliations

Chronic Kidney Disease and Diabetic Retinopathy in Patients with Type 2 Diabetes

Antonio Rodríguez-Poncelas et al. PLoS One. .

Abstract

Purpose: To explore the relationship between chronic kidney disease (CKD) and diabetic retinopathy (DR) in a representative population of type 2 diabetes mellitus (DM2) patients in Catalonia (Spain).

Methods: This was a population-based, cross-sectional study. A total of 28,344 patients diagnosed with DM2 who had recorded ophthalmologic and renal functional examinations were evaluated. Data were obtained from a primary healthcare electronic database of medical records. CKD was defined as an estimated glomerular filtration ratio (eGFR) of <60 ml/min/1.73 m2 and/or urine albumin to creatinine ratio (UACR) ≥30 mg/g. DR was categorized as non-vision threatening diabetic retinopathy and vision threatening diabetic retinopathy.

Results: CKD was associated with a higher rate of DR [OR], 95% confidence interval [CI], 1.5 (1.4-1.7). When we analyzed the association between different levels of UACR and DR prevalence observed that DR prevalence rose with the increase of UACR levels, and this association was significant from UACR values ≥10 mg/g, and increased considerably with UACR values ≥300 mg/g (Odds ratio [OR], 95% confidence interval [CI], 2.0 (1.6-2.5). This association was lower in patients with eGFR levels 44 to 30 mL/min/1.73 m2 [OR], 95% confidence interval [CI], 1.3 (1.1-1.6).

Conclusions: These results show that CKD, high UACR and/or low eGFR, appear to be associated with DR in this DM2 population.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Urine albumin to creatinine ratio and prevalence of diabetic retinopathy.
*Adjusted by age, sex, age at retinography, duration type 2 diabetes, systolic blood pressure <140 mmHg, A1C ≤ 7%, smoking, cardiovascular disease, BMI, and eGFR. DR, diabetic retinopathy; OR, odds ratio; UACR, urine albumin to creatinine ratio.
Fig 2
Fig 2. Association of chronic kidney disease and diabetic retinopathy.
*Adjusted by sex, age at digital photography, duration of type 2 diabetes, systolic blood pressure <140 mmHg, and A1C ≤7%; DR, diabetic retinopathy; eGFR, estimated glomerular filtration rate; UACR, urine albumin to creatinine ratio; VTDR, vision threatening diabetic retinopathy (severe non proliferative DR, proliferative DR, and diabetic macular edema); non-VTDR, mild non-proliferative DR and moderate non-proliferative DR.
See this image and copyright information in PMC

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