Intravitreal Vascular Endothelial Growth Factor Inhibitor Use and Renal Function Decline in Patients with Diabetic...

Area of Science:

• Ophthalmology
• Nephrology
• Endocrinology

Background:

• Systemic vascular endothelial growth factor (VEGF) inhibitors are known to cause adverse renal effects.
• Diabetic retinopathy is a common complication of diabetes, and its management often involves VEGF inhibitors.
• The impact of intravitreal VEGF inhibitor use on renal function in diabetic retinopathy patients requires further investigation.

Purpose of the Study:

• To investigate the association between intravitreal VEGF inhibitor use and renal function decline in patients with diabetic retinopathy.
• To identify risk factors for renal function decline in this patient population.

Main Methods:

• A cohort of 625 patients with diabetic retinopathy was included, with regular renal function follow-ups.
• Patients were grouped based on intravitreal therapy: 67 treated and 558 untreated.
• A generalized estimating equation model was employed to analyze renal function decline risk factors.

Main Results:

• Increased age, insulin use, hypertension, and ischemic heart disease were significantly associated with decreased estimated glomerular filtration rates (eGFRs).
• Patients receiving intravitreal VEGF inhibitors showed a non-statistically significant trend of declining eGFR (p=0.06).
• Subgroup analysis revealed significantly decreased renal function in patients with initial eGFR ≤ 30 mL/min/1.73 m² who received intravitreal VEGF inhibitors (p<0.01).

Conclusions:

• Intravitreal VEGF inhibitor injection is associated with renal function deterioration in diabetic retinopathy patients with advanced chronic kidney disease.
• Close renal function monitoring should be considered for high-risk populations undergoing intravitreal VEGF inhibitor treatment.
• The findings highlight the importance of a multidisciplinary approach in managing diabetic retinopathy patients with pre-existing renal impairment.