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Ischemic diabetic retinopathy as a possible prognostic factor for chronic kidney disease progression
- Publication Year :
- 2014
- Publisher :
- Nature Publishing Group, 2014.
-
Abstract
- To assess the value of diabetic retinopathy (DR) severity as a possible predictive prognostic factor for the progression of chronic kidney disease (CKD).Retrospective cohort study. Patients (51) who were initially diagnosed with DR and CKD were enrolled and their medical records were evaluated. The following ophthalmic factors were assessed by fluorescein angiography at the initial visit: area of capillary nonperfusion, presence of neovascularization and vitreous hemorrhage, and DR grade. The effect of these factors on CKD progression over the 2-year period of the study, defined as doubling of serum creatinine or the development of end-stage renal disease requiring dialysis or renal transplant, was evaluated.The study included 51 patients with DR and CKD; of these, 11 patients (21.6%) were found to have proliferative DR (PDR) and seven patients (13.7%) had high-risk PDR at baseline. Patients with ischemic DR, who showed extensive capillary nonperfusion (≥ 10 optic disc areas) in the retina, had a greater risk for CKD progression (hazard ratio = 6.64; P = 0.002).We found that extensive capillary nonperfusion in the retina greatly increased the risk of progression of CKD in patients with DR. This suggests that the retina and the kidney may have shared risk factors for microvascular disease secondary to diabetes mellitus, and emphasizes the need for a team approach to diabetes care.
- Subjects :
- Adult
Male
medicine.medical_specialty
Ischemia
Renal function
Retinal Neovascularization
Gastroenterology
Cohort Studies
chemistry.chemical_compound
Risk Factors
Ophthalmology
Internal medicine
medicine
Humans
Fluorescein Angiography
Renal Insufficiency, Chronic
Kidney transplantation
Aged
Retrospective Studies
Creatinine
Diabetic Retinopathy
medicine.diagnostic_test
urogenital system
business.industry
Retinal Vessels
Retrospective cohort study
Diabetic retinopathy
Middle Aged
medicine.disease
Fluorescein angiography
Prognosis
Kidney Transplantation
Vitreous Hemorrhage
chemistry
Clinical Study
Disease Progression
Kidney Failure, Chronic
Female
business
Kidney disease
Glomerular Filtration Rate
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....8890e8e61182ede4935fda01abc9856b