Kidney Week

Abstract: FR-PO464

Diabetic Retinopathy Is Associated with Renal Function Deterioration in Korean Population with Type 2 Diabetes

Session Information

• Diabetic Kidney Disease: Clinical - I
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Park, Hayne C., Kangnam Sacred Heart Hospital, Seoul, Seoul, Korea (the Republic of)

Hayne C. Park,

• Noh, Jung-woo, Dr. Chun & Cho's Medical Clinic & Dialysis Center, Seoul, Korea (the Republic of)

Jung-woo Noh,

• Han, Chaehoon, Kangnam Sacred Heart Hospital, Seoul, Seoul, Korea (the Republic of)

Chaehoon Han,

• Shin, Young joo, Kangnam Sacred Heart Hospital, Seoul, Seoul, Korea (the Republic of)

Young joo Shin,

• Lee, Youngki, Kangnam Sacred Heart Hospital, Seoul, Seoul, Korea (the Republic of)

Youngki Lee,

Group or Team Name

• Hallym University Kidney Research Institute

Background

Although both retinopathy and nephropathy are major diabetic microvascular complications, a few studies have examined the relationship between retinal structural changes and renal functions in patients with diabetes. We investigated whether diabetic retinopathy (DR) status has adverse effects on kidney function in patients with type 2 diabetes.

Methods

We enrolled 2,139 patients with type 2 diabetes who had undergone fundus exam and serial renal function evaluation from August 2006 to February 2014. DR status was classified to no DR, non-proliferative DR (NPDR), and proliferative DR (PDR). Cox regression analysis was used to evaluate the hazard ratio for renal function decline according to DR status.

Results

The mean age of the study participants was 58.3±11.3 years and 1,124 (52.5%) were women. The mean follow-up period was 3.1±2.9 years. DR was associated with the change in estimated glomerular filtration rate (eGFR) and the development of renal dysfunction (decreased eGFR〉20%) (no DR group 2.23±24.51; NPDR group -2.82±24.11; PDR group -4.82±46.63 mL/min/1.73m²/year, P〈0.001). After adjustments for other risk factors, DR was an independent predictor for renal function deterioration (HR 1.917, 95% CI 1.470–2.498, P〈0.001). In addition, the progression of DR (new-onset DR or progression of DR status) was associated with the change in eGFR (no DR progression group 0.86±19.77, DR progression group -1.75±14.24 mL/min/1.73m²/year; P〈0.001). After adjustments for risk factors, however, DR progression was not an independent predictor for renal function deterioration (HR 1.374, 95% CI 0.748–2.523, P=0.305). On the other hands, DR was associated with the development of proteinuria during follow-up periods (no DR group 6.2%; NPDR group 17.5%; PDR group 30.1%, P〈0.001). Progression of DR was also associated with the development of proteinuria during follow-up periods (no DR progression group 9.1%; DR progression group 17.1%, P=0.013). Multivariate analysis demonstrated that the status of DR as well as eGFR and HbA1c is an independent predictor for development of proteinuria.

Conclusion

Our findings showed a strong association between DR and progressive renal dysfunction after adjustment for traditional and non-traditional risk factors in Korean patients with type 2 diabetes.

Funding

• Government Support - Non-U.S.