Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Mar;69(2):245-252.
doi: 10.1007/s10384-025-01170-x. Epub 2025 Feb 28.

Longitudinal renal function changes during real-world anti-vascular endothelial growth factor therapy for diabetic macular edema in Japan

Ayumi Usui-Ouchi  1 , Shuta Kishishita  2 , Yoshihito Sakanishi  2 , Keitaro Mashimo  2 , Kazunori Tamaki  2 , Moe Matsuzawa  2 , Meiko Kimura  2 , Riyu Ikari  2 , Shuu Morita  2 , Ishin Ninomiya  2 , Toshiro Sakuma  2 , Nobuyuki Ebihara  2 , Shintaro Nakao  3
Affiliations
Observational Study

Longitudinal renal function changes during real-world anti-vascular endothelial growth factor therapy for diabetic macular edema in Japan

Ayumi Usui-Ouchi et al. Jpn J Ophthalmol. 2025 Mar.

Abstract

Purpose: This retrospective observational study aimed to investigate the longitudinal changes in renal function and central macular thickness (CMT) and their impact on visual outcomes during anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME).

Study design: This study employed a retrospective observational design and analyzed data from treatment-naive patients with DME (62 cases, 100 eyes) receiving anti-VEGF therapy for 36 months. Baseline and follow-up assessments were conducted at 12, 24, and 36 months.

Methods: Best corrected visual acuity (BCVA), CMT, number of anti-VEGF injections, HbA1c, serum creatinine (Cre), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary protein levels, and chronic kidney disease (CKD) stage were measured at each time point.

Results: The study population had a mean age of 60.7 ± 12.2 years, with 41 men and 21 women. Over the 36-month period, the mean number of anti-VEGF injections per eye was 5.3 ± 3.3. Maximum CMT significantly decreased at each time point, and final BCVA showed significant improvement (logMAR: - 0.07). HbA1c levels remained stable, BUN and Cre levels increased, and eGFR decreased significantly over time. CKD stage 3+ at 36 months significantly resulted in worse CMT.

Conclusion: This retrospective observational study provides valuable insights into the longitudinal changes in renal function and CMT during anti-VEGF therapy for DME. Our findings emphasize the importance of monitoring renal function. This study contributes to our understanding of the complex relationship between renal function, DME, and anti-VEGF therapy, thereby facilitating improved management and outcomes in patients with DME.

Keywords: Anti-VEGF; Diabetic kidney disease; Diabetic macular edema; Diabetic retinopathy; Renal function.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of interest: A. U-Ouchi, Grants or contracts (Bayer), Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Bayer, Chugai, Santen, Senju, Novartis); S. Kishishita, None; Y. Sakanishi, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Bayer, Chugai, Santen, Senju, Novartis); K. Mashimo, None; K.Tamaki, None; M. Matsuzawa, None; M. Kimura, None; R. Ikari, None; S. Morita, None; I. Ninomiya, None; T. Sakuma, None; N. Ebihara, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Santen, Senju); S. Nakao, Grants or contracts (Alcon, Otsuka, HANDAYA, Santen, HOYA, Seed, IWAKI OPTICAL, Senju, JFC Sales Plan, TOMEY, Kowa, WAKAMOTO), Consulting fees (Alcon, Boehringer Ingelheim, Bayer, Novartis, Chugai, RIVERFIELD, Kowa, Senju), Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events (Alcon, Boehringer Ingelheim, Bayer, Novartis, Chugai, Novo Nordisk, JFC Sales Plan, Otsuka, Johnson & Johnson, Santen, Kowa, Senju, Machida Endoscope, WAKAMOTO, Mitsubishi Tanabe Pharma), Support for attending meetings and/or travel (Chugai, Novartis, NIPRO, Sumitomo), Patents planned, issued or pending (RIVERFIELD).

Figures

Fig. 1
Fig. 1
Longitudinal Changes in HbA1c, serum Cre, serum BUN, and eGFR. Longitudinal changes in HbA1c (a), serum creatinine (b), serum BUN (c), and eGFR (d) levels are shown. Statistical analysis was performed using repeated-measures ANOVA. *p<0.05, **p<0.01, ***p<0.001, and ****p<0.0001. Cre creatinine, BUN blood urea nitrogen, eGFR estimated glomerular filtration rate, HbA1c hemoglobin A1c, Cre creatinine, BUN blood urea nitrogen, eGFR estimated glomerular filtration rate
Fig. 2
Fig. 2
The longitudinal changes in urinary protein levels and CKD stages. Longitudinal changes in urinary protein levels (a) and CKD stage (b) are shown. CKD chronic kidney disease
See this image and copyright information in PMC

References

    1. Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabet Care. 2012;35:556–64. - PMC - PubMed
    1. Bressler NM, Beaulieu WT, Glassman AR, Blinder KJ, Bressler SB, Jampol LM, et al. Persistent macular thickening following intravitreous aflibercept, bevacizumab, or ranibizumab for central-involved diabetic macular edema with vision impairment: a secondary analysis of a randomized clinical trial. JAMA Ophthalmol. 2018;136:257–69. - PMC - PubMed
    1. Hsieh YT, Tsai MJ, Tu ST, Hsieh MC. Association of abnormal renal profiles and proliferative diabetic retinopathy and diabetic macular edema in an asian population with type 2 diabetes. JAMA Ophthalmol. 2018;136:68–74. - PMC - PubMed
    1. Yamamoto M, Fujihara K, Ishizawa M, Osawa T, Kaneko M, Ishiguro H, et al. Overt proteinuria, moderately reduced eGFR and their combination are predictive of severe diabetic retinopathy or diabetic macular edema in diabetes. Invest Ophthalmol Vis Sci. 2019;60:2685–9. - PubMed
    1. Hammes HP, Welp R, Kempe HP, Wagner C, Siegel E, Holl RW, et al. Risk factors for retinopathy and DME in type 2 diabetes-results from the German/Austrian DPV database. PLoS ONE. 2015;10: e0132492. 10.1371/journal.pone.0132492. - PMC - PubMed

Publication types

MeSH terms

Grants and funding