Association of diabetic retinopathy and diabetic macular oedema with renal function in southern Chinese patients with type 2 diabetes mellitus: a single-centre observational study

BMJ Open. 2019 Sep 6;9(9):e031194. doi: 10.1136/bmjopen-2019-031194.

Abstract

Background and objectives: The association of diabetic retinopathy (DR) and diabetic macular oedema (DME) with renal function in southern Chinese patients with diabetes is poorly understood. So we aimed to study the correlation between stage of DR and DME with stage of estimated glomerular filtration rate (eGFR) and stage of urine albumin-to-creatinine ratio (UACR), and to explore the systemic risk factors for DR and DME.

Design and setting: This single-centre retrospective observational study was conducted from December 2017 to November 2018.

Participants: 413 southern Chinese patients with type 2 diabetes mellitus.

Outcome measures: The correlations between stage of DR and DME with stage of eGFR/UACR were assessed by Spearman's or χ² analyses and represented with histograms. Risk factors associated with the occurrence of DR and DME were performed by logistic regression and represented with nomograms.

Results: Stage of DR had a positive correlation with stage of eGFR (r=0.264, p<0.001) and stage of UACR (r=0.542, p<0.001). With the stage of eGFR/UACR being more severe, the prevalence of DME became higher as well (both p<0.001). The risk factors for DR were DM duration (OR 1.072; 95% CI 1.032 to 1.114; p<0.001), stage of UACR (OR 2.001; 95% CI 1.567 to 2.555; p<0.001) and low-density lipoprotein (LDL) (OR 1.301; 95% CI 1.139 to 1.485; p<0.001), while risk factors for DME were stage of UACR (OR 2.308; 95% CI 1.815 to 2.934; p<0.001) and LDL (OR 1.460; 95% CI 1.123 to 1.875; p=0.008).

Conclusions: Among southern Chinese patients, stage of DR and DME were positively correlated with renal function, while stage of UACR performed a better relevance than stage of eGFR.

Keywords: Chronic kidney disease; Diabetic macular oedema; Diabetic retinopathy; Nomogram; Risk factors.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Albuminuria / urine
  • China / epidemiology
  • Creatinine / urine
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / epidemiology
  • Diabetic Retinopathy / etiology*
  • Disease Progression
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney / physiopathology*
  • Logistic Models
  • Macular Edema / diagnosis
  • Macular Edema / epidemiology
  • Macular Edema / etiology*
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors

Substances

  • Creatinine