Cho AJin, Park Hayne Cho, Lee Young-Ki, Shin Young Joo, Bae So Hyun, Kim Hakyoung
Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Hallym University Kidney Research Institute, Seoul, Republic of Korea.
J Diabetes Res. 2020 Jul 26;2020:8784139. doi: 10.1155/2020/8784139. eCollection 2020.
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.
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.
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, = 0.013) was an independent risk factor for progression of DR in patients with NPDR.
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.
在韩国的一家大学医院，我们进行了一项回顾性研究，以确定2型糖尿病患者糖尿病视网膜病变（DR）进展与肾功能下降之间的关联。
我们纳入了2006年8月至2014年2月期间在我们糖尿病诊所随访并接受眼底照相检查的总共1527例2型糖尿病患者。视网膜眼科医生通过全面的眼科检查对DR进行评估。
非增殖性DR（NPDR）和增殖性DR（PDR）的基线患病率分别为26.5%和14.7%。在1303例无DR和NPDR的患者中，134例（10.3%）进展为NPDR或PDR。进展组糖尿病病程更长，空腹血糖更高，糖化血红蛋白更高，且随访期间估算肾小球滤过率（eGFR）下降≥20%的比例更高。多因素分析后，eGFR下降≥20%（比值比2.553，95%置信区间1.219 - 5.348，P = 0.013）是NPDR患者DR进展的独立危险因素。
肾功能下降与NPDR患者的DR进展独立相关，提示对于肾功能下降的患者应建议检查DR状态。
