Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea.
Institute of Medical Science, Ajou University School of Medicine, Suwon, Korea.
Transl Vis Sci Technol. 2020 Mar 9;9(4):4. doi: 10.1167/tvst.9.4.4. eCollection 2020 Mar.
Proteinuria is the second most common complication after hypertension after systemic administration of bevacizumab. Therefore we aimed to analyze the effect of intravitreal bevacizumab (IVB) injection on proteinuria in patients with diabetes.
Patients scheduled to receive IVB injection from May 1, 2018, to December 31, 2018, were prospectively enrolled. In total, 53 patients with diabetes (26 with nonproliferative diabetic retinopathy and 27 with proliferative diabetic retinopathy) and 37 patients without diabetes were included. Urine tests were performed within 1 month of and 7 ± 1 days after IVB injection. Urinary protein, creatinine, and albumin concentrations were quantitatively measured, and urinary protein-to-creatinine ratio and urinary albumin-to-creatinine ratio (UACR) were calculated from these data before and after IVB injection.
The mean urinary microalbumin concentrations and urinary protein-to-creatinine ratio were significantly higher in patients with diabetes, both before and after IVB injection. There were no differences between patients with nonproliferative diabetic retinopathy and proliferative diabetic retinopathy. About 80% of patients with diabetes showed improved albuminuria or at least no harmful effect in terms of albuminuria. Patients with deteriorated baseline UACR showed more residual increase in UACR after IVB injection ( < 0.05 in all groups).
Close monitoring of renal function after IVB might be needed in patients with diabetes according to the severity of nephropathy.
Our results may provide information regarding the renal function of IVB-treated patients with diabetes.
贝伐单抗全身给药后，蛋白尿是继高血压之后的第二大常见并发症。因此，我们旨在分析玻璃体内注射贝伐单抗（IVB）对糖尿病患者蛋白尿的影响。
前瞻性纳入 2018 年 5 月 1 日至 2018 年 12 月 31 日期间拟接受 IVB 注射的患者。共纳入 53 例糖尿病患者（26 例非增殖性糖尿病视网膜病变，27 例增殖性糖尿病视网膜病变）和 37 例非糖尿病患者。在 IVB 注射前 1 个月内和注射后 7±1 天进行尿液检查。定量测量尿液中蛋白、肌酐和白蛋白浓度，并根据这些数据计算 IVB 注射前后的尿蛋白/肌酐比值和尿白蛋白/肌酐比值（UACR）。
糖尿病患者的尿微量白蛋白浓度和尿蛋白/肌酐比值均显著高于 IVB 注射前后。非增殖性糖尿病视网膜病变和增殖性糖尿病视网膜病变患者之间无差异。约 80%的糖尿病患者的白蛋白尿得到改善，或至少白蛋白尿没有恶化。基线 UACR 恶化的患者在 IVB 注射后 UACR 残留增加更多（所有组均<0.05）。
根据肾病的严重程度，糖尿病患者在接受 IVB 治疗后可能需要密切监测肾功能。
钱林婧
