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Observational Study
. 2020 Jul 26:2020:8784139.
doi: 10.1155/2020/8784139. eCollection 2020.

Progression of Diabetic Retinopathy and Declining Renal Function in Patients with Type 2 Diabetes

AJin Cho  1   2 , Hayne Cho Park  1   2 , Young-Ki Lee  1   2 , Young Joo Shin  3 , So Hyun Bae  3 , Hakyoung Kim  3
Affiliations
Observational Study

Progression of Diabetic Retinopathy and Declining Renal Function in Patients with Type 2 Diabetes

AJin Cho et al. J Diabetes Res. .

Abstract

Background: At a university hospital in Korea, we conducted a retrospective study to determine the association of the progression of diabetic retinopathy (DR) with declining renal function in type 2 diabetes.

Methods: We included a total of 1527 patients with type 2 diabetes who followed up in our diabetes clinic and underwent fundus photographic examinations from August 2006 to February 2014. DR was assessed by retinal ophthalmologists using comprehensive ophthalmologic examinations.

Results: The baseline prevalence of nonproliferative DR (NPDR) and proliferative DR (PDR) was 26.5% and 14.7%, respectively. Among 1303 patients with no DR and NPDR, 134 (10.3%) patients progressed to NPDR or PDR. The progression group had longer duration of diabetes, higher fasting plasma glucose, higher HbA1c, and a higher rate of ≥20% decline in eGFR during the follow-up period. After multivariate analysis, ≥20% decline in eGFR (odds ratio 2.553, 95% CI 1.219-5.348, p = 0.013) was an independent risk factor for progression of DR in patients with NPDR.

Conclusion: Declining renal function was independently associated with DR progression in patients with NPDR, suggesting that investigation of DR status should be recommended for patients with declining renal function.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Prevalent diabetic retinopathy and renal function. (a) eGFR category: G1 (≥90), G2 (60–89), G3 (30–59), and G4 (15–29 ml/min/1.73m2) and (b) albuminuria. Abbreviation: eGFR: estimated glomerular filtration rate.
Figure 2
Figure 2
Changes of renal function in both groups. (a) Mean eGFR change. (b) Rate of ≥20% decline in eGFR during the follow-up period. (c) Albuminuria development. Abbreviation: eGFR: estimated glomerular filtration rate.
See this image and copyright information in PMC

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