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Author Spotlight: Understanding Retinal Vessel Resilience and Disease Progression
Published on: January 12, 2024
Associations between diabetic retinopathy and disease severity of diabetic nephropathy in patients with type 2
Jia-Hui Zhang1, Jian-Chen Hao2, Dong-Yuan Chang1
1Renal Division, Department of Medicine, Peking University First Hospital, No. 8 of Xishiku Street, Xicheng District, Beijing, 100034, PR China; Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, PR China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, PR China.
Background:
Diabetic nephropathy (DN) and diabetic retinopathy (DR) are two major microvascular complications of diabetes mellitus (DM); however, the association of the severity and progression between these two diabetic complications remains unclear.
Methods:
This retrospective study included 303 biopsy-confirmed DN patients with type 2 DM (T2DM), stratified by DR status [proliferative DR (PDR) and diabetic macular edema (DME)] via fundus imaging and optical coherence tomography (OCT). Renal outcomes were evaluated using Kaplan-Meier analysis and Cox regression models, with between-group comparisons and correlations assessed using corresponding statistical tests.
Results:
Patients with DR, particularly those with advanced DR (PDR or DME) had heavier proteinuria, more severe renal pathology, characterized by higher class (III/IV), more severe interstitial fibrosis and tubular atrophy, and a higher prevalence of Kimmelstiel-Wilson nodules. Central retinal thickness correlated positively with proteinuria and serum total cholesterol, negatively with hemoglobin and serum albumin. The presence of DR or DME was to some extent associated with adverse renal outcomes.
Conclusion:
Collectively, these findings indicate that the presence and severity of DR reflect more advanced DN in patients with T2DM-associated DN. Further investigation is needed to extrapolate the findings to a broader T2DM population.
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