Department of Ophthalmology, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya Chennai, Tamil Nadu, India.
National Institute of Epidemiology, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2024 Jul 1;72(7):968-975. doi: 10.4103/IJO.IJO_2558_23. Epub 2024 Mar 8.
To investigate the influence of glomerular filtration rate in renal disease decline and its association with diabetic retinopathy (DR) and age-related macular degeneration (ARMD) in patients in South India.
A population-based cross-sectional study was conducted including participants with DR and ARMD recruited from urban and rural populations. The data collection included medical history, anthropometric measurements, and ophthalmic work-up. The estimated glomerular filtration rate (eGFR) was calculated using the equation of chronic kidney disease-epidemiology collaboration (CKD-EPI). The grading of AMD was done by a single experienced (more than 5 years) vitreoretinal surgeon as per the International ARM Epidemiological Study Group and it was staged based on grading in the worsened eye.
A decline in eGFR was observed as the severity of DR increased ( P < 0.001). Baseline characteristics such as age ( P < 0.001), duration of diabetes ( P < 0.001), gender ( P < 0.001), creatinine ( P < 0.001), albumin to creatinine ratio (ACR; P < 0.001), albuminuria ( P = 0.023), blood urea ( P < 0.001), and high-density lipoprotein (HDL; P = 0.003) were found to be statistically significant. The risk for developing DR with CKD was found to be 5 times higher in male patients compared to female patients. Age and high blood urea level, diastolic blood pressure, mild and moderate DR were the risk factors associated with CKD. A decline in eGFR was observed as the severity of ARMD increased ( P < 0.001). The risk factors associated with CKD were age, gender, smoking, alcohol consumed, presence of hypertension, duration of diabetes, systolic and diastolic blood pressure, history of diabetes, body mass index (BMI), serum triglycerides, and serum HDL cholesterol.
Reduced eGFR values were associated with an increase in the severity of DR and ARMD.
研究肾小球滤过率在南印度肾病患者中的下降及其与糖尿病视网膜病变（DR）和年龄相关性黄斑变性（ARMD）的关系。
进行了一项基于人群的横断面研究，包括从城市和农村人群中招募的 DR 和 ARMD 患者。数据收集包括病史、人体测量学测量和眼科检查。使用慢性肾脏病流行病学合作（CKD-EPI）方程计算估计肾小球滤过率（eGFR）。AMD 的分级由一位经验丰富的（超过 5 年）玻璃体视网膜外科医生根据国际 ARMD 流行病学研究组进行，并根据病变加重眼的分级进行分期。
随着 DR 严重程度的增加，eGFR 下降（P < 0.001）。年龄（P < 0.001）、糖尿病病程（P < 0.001）、性别（P < 0.001）、肌酐（P < 0.001）、白蛋白与肌酐比值（ACR；P < 0.001）、蛋白尿（P = 0.023）、血尿素（P < 0.001）和高密度脂蛋白（HDL；P = 0.003）等基线特征差异有统计学意义。与女性患者相比，男性患者发生 DR 合并 CKD 的风险高 5 倍。年龄和高血尿素水平、舒张压、轻度和中度 DR 是与 CKD 相关的危险因素。随着 ARMD 严重程度的增加，eGFR 下降（P < 0.001）。与 CKD 相关的危险因素包括年龄、性别、吸烟、饮酒、高血压、糖尿病病程、收缩压和舒张压、糖尿病史、体重指数（BMI）、血清甘油三酯和血清 HDL 胆固醇。
eGFR 值降低与 DR 和 ARMD 严重程度的增加相关。
