Tamadon Mohammad-Reza, Ghorbani Raheb, Rezaei Samaneh, Daraei Gholamreza
Department of Internal medicine, Semnan University of Medical Sciences, Semnan, Iran.
Research Center for Social Determinants of Health , Department of Community Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
J Renal Inj Prev. 2015 Mar 1;4(1):11-4. doi: 10.12861/jrip.2015.04. eCollection 2015.
Retinopathy and nephropathy are long-term diabetes complications which are associated together. Renal dysfunction is a risk factor for progression and deterioration of diabetic retinopathy. Diabetes causes damage to the small blood vessels in the retina and kidney which eventually resulted in diabetic nephropathy, renal failure and blindness. Due to the high cost for treating of these complications it is better to prevent them.
We aimed to assess the patients' kidney function and retinal status in a group of diabetic patients to find probable association between nephropathy and retinopathy hence can prevent from serious renal complications.
In this cross-sectional study 253 patients with type 2 diabetes referring to ophthalmology clinics were evaluated. Eye examination was conducted by an ophthalmologist (vitreoretinal subspecialist) and disease stage was determined, then serum blood urea nitrogen (BUN) and creatinine tests and 24-hour urine collection for microalbuminuria were measured.
Mean of BUN and microalbuminuria had significant difference in three groups including proliferative retinopathy, non-proliferative retinopathy and patients without retinopathy. The mean (± SD) of serum creatinine in patients with proliferative retinopathy, non-proliferative retinopathy and patients without retinopathy had no significant difference.
The presence or absence of retinopathy in the early stages of diabetic kidney disease has not related to renal involvement, in fact, patients without retinopathy may have renal involvement. In periodic examination, diabetic patients should be evaluated for microalbuminuria in addition to renal function test examination.
视网膜病变和肾病是相互关联的糖尿病长期并发症。肾功能不全是糖尿病视网膜病变进展和恶化的危险因素。糖尿病会损害视网膜和肾脏中的小血管，最终导致糖尿病肾病、肾衰竭和失明。由于治疗这些并发症的成本高昂，最好进行预防。
我们旨在评估一组糖尿病患者的肾功能和视网膜状况，以发现肾病和视网膜病变之间可能存在的关联，从而预防严重的肾脏并发症。
在这项横断面研究中，对253名前往眼科诊所就诊的2型糖尿病患者进行了评估。由一名眼科医生（玻璃体视网膜专科医生）进行眼部检查并确定疾病阶段，然后检测血清血尿素氮（BUN）和肌酐，并收集24小时尿液以检测微量白蛋白尿。
在增殖性视网膜病变、非增殖性视网膜病变和无视网膜病变的三组患者中，BUN平均值和微量白蛋白尿存在显著差异。增殖性视网膜病变患者、非增殖性视网膜病变患者和无视网膜病变患者的血清肌酐平均值（±标准差）无显著差异。
糖尿病肾病早期视网膜病变的有无与肾脏受累无关，事实上，无视网膜病变的患者可能存在肾脏受累情况。在定期检查中，糖尿病患者除了进行肾功能检查外，还应评估微量白蛋白尿。
