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. 2025 Mar 27;87(4):1897-1903.
doi: 10.1097/MS9.0000000000003090. eCollection 2025 Apr.

Association between chronic kidney disease severity and retinopathy in hypertensive, diabetic, and mixed retinopathy in Nepal: a cross-sectional study

Gunjan Prasai  1   2   3 , Sabina Shrestha  2 , Priyanka Shrestha  1 , Kiran Shakya  1 , Rupesh Agrawal  4   5 , Anadi Khatri  6   7   8
Affiliations

Association between chronic kidney disease severity and retinopathy in hypertensive, diabetic, and mixed retinopathy in Nepal: a cross-sectional study

Gunjan Prasai et al. Ann Med Surg (Lond). .

Abstract

Introduction: Hypertensive, diabetic, and mixed retinopathies are prevalent ocular conditions that can serve as indicators of systemic diseases, particularly chronic kidney disease (CKD). The association between the severity of these retinopathies and the grading of CKD remains under-explored. This study aims to elucidate the correlation between the severity of hypertensive, diabetic, or mixed retinopathies and the stages of CKD, providing insights into the interconnected pathophysiology of these conditions.

Methodology: A cross-sectional study was conducted involving 100 patients diagnosed with hypertensive, diabetic, or mixed retinopathies. Participants were categorized based on their retinopathy type and severity using standardized grading systems. CKD staging was determined according to the kidney disease guidelines. Data were collected through comprehensive ophthalmic examinations, retinal imaging's and patient medical histories. Statistical analysis was performed to assess the association between retinopathy severity and CKD stages using odds ratio (OR).

Results: The study found a significant positive correlation between the severity of retinopathies and the stages of CKD. Hypertensive Retinopathy with visual morbidity and complications was found to be associated with greater severity of CKD (OR = 2.98, P = 0.014). Patients with advanced CKD stages had more severe diabetic retinopathy compared to those with lesser severity with OR of 3.60 (P = 0.013). Mixed retinopathy had the strongest association with severity of CKD with OR of 9.07; P = 0.002).

Conclusion: The severity of hypertensive, diabetic, and mixed retinopathies correlates strongly with CKD progression. These findings highlight the need for integrated care models emphasizing regular ophthalmic and renal evaluations in at-risk populations. Early detection and management of retinopathies may facilitate timely intervention for CKD, reducing systemic disease burden.

Keywords: chronic kidney disease; diabetes; hypertension; mixed retinopathy; retinopathy severity.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. None.

Figures

Figure 1.
Figure 1.
Distribution of patients according to age.
Figure 2.
Figure 2.
Distribution of best corrected visual acuity.
Figure 3.
Figure 3.
Comorbid conditions present in the patients.
Figure 4.
Figure 4.
Distribution of patients with hypertensive retinopathy according to CKD stages.
Figure 5.
Figure 5.
Distribution of patients with diabetic retinopathy according to CKD stages.
See this image and copyright information in PMC

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