Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia; Wardliparingga Aboriginal Health Equity Theme, South Australia Health and Medical Research Institute, Adelaide, Australia.
Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia.
Prim Care Diabetes. 2024 Oct;18(5):547-554. doi: 10.1016/j.pcd.2024.08.005. Epub 2024 Sep 3.
Diabetic nephropathy, vision loss and diabetic retinopathy (DR) are frequent comorbidities among individuals with type 2 diabetes (T2D). The Retinopathy in People Currently On Renal Dialysis (RiPCORD) study sought to examine the epidemiology and risk of vision impairment (VI) and DR among a cohort of Indigenous and non-Indigenous Australians with T2D currently receiving haemodialysis for end-stage renal failure (ESRF).
A total of 106 Indigenous and 109 non-Indigenous Australians were recruited in RiPCORD across five haemodialysis centres in urban and remote settings. Clinical assessments, questionnaires and medical record data determined the rates of ocular complications and risk factor profiles.
Prevalence rates include unilateral VI, 23.5 %; bilateral VI, 11.7 %; unilateral blindness, 14.2 %; and bilateral blindness, 3.7 %, with no significant differences between sub-cohorts (p=0.30). DR prevalence rates were 78.0 % among non-Indigenous Australians and 93.1 % among Indigenous Australians (p=<0.001). Non-Indigenous ethnicity (OR: 0.28) and pre-dialysis diastolic blood pressure (OR: 0.84 per 10-mmHg) were protective, while peripheral vascular disease (OR: 2.79) increased DR risk.
Ocular complications among individuals with T2D and ESRF are disproportionately high, especially for Indigenous Australians, and beyond what can be accounted for by risk factor variation. Findings suggest a need to improve screening and preventative efforts within this high-risk population group.
糖尿病肾病、视力丧失和糖尿病视网膜病变（DR）是 2 型糖尿病（T2D）患者常见的合并症。正在进行的透析人群视网膜病变（RiPCORD）研究旨在检查目前正在接受血液透析治疗终末期肾衰竭（ESRF）的 T2D 澳大利亚原住民和非原住民人群中视力障碍（VI）和 DR 的流行病学和风险。
RiPCORD 在城市和偏远地区的五个血液透析中心共招募了 106 名原住民和 109 名非原住民澳大利亚人。临床评估、问卷调查和病历数据确定了眼部并发症和危险因素的发生率。
单侧 VI 的患病率为 23.5%；双侧 VI 的患病率为 11.7%；单侧失明的患病率为 14.2%；双侧失明的患病率为 3.7%，亚组之间无显著差异（p=0.30）。非原住民澳大利亚人的 DR 患病率为 78.0%，而原住民澳大利亚人的 DR 患病率为 93.1%（p<0.001）。非原住民种族（OR：0.28）和透析前舒张压（OR：每 10mmHg 降低 0.84）具有保护作用，而外周血管疾病（OR：2.79）则增加了 DR 的风险。
T2D 和 ESRF 患者的眼部并发症发生率过高，尤其是原住民澳大利亚人，超出了危险因素变化可以解释的范围。研究结果表明，需要在这一高危人群中加强筛查和预防工作。
