Glomerular Filtration Rate and/or Ratio of Urine Albumin to Creatinine as Markers for Diabetic Retinopathy. A Ten-Year Follow-Up Study

Identifier:  imarina:5132048

Handle: https://hdl.handle.net/20.500.11797/imarina5132048

Authors:  Romero-Aroca, Pedro; Baget-Bernaldiz, Marc; Navarro-Gil, Raul; Moreno-Ribas, Antonio; Valls-Mateu, Aida; Sagarra-Alamo, Ramon; Barrot-De La Puente, Joan F; Mundet-Tuduri, Xavier

Abstract:
Aims. To determine the relationship between diabetic nephropathy and diabetic retinopathy on a population of type 2 diabetes mellitus patients. Methods. A prospective ten-year follow-up population-based study. We determined differences between estimated glomerular filtration rate (eGFR) using the chronic kidney disease epidemiology collaboration equation and urine albumin to creatinine ratio. Results. Annual incidence of any-DR was 8.21 ± 0.60% (7.06%-8.92%), sight-threatening diabetic retinopathy (STDR) was 2.65 ± 0.14% (2.48%-2.88%), and diabetic macular edema (DME) was 2.21 ± 0.18% (2%-2.49%). Renal study results were as follows: UACR > 30 mg/g had an annual incidence of 7.02 ± 0.05% (6.97%-7.09%), eGFR < 60 ml/min/1.73 m2 incidence was 5.89 ± 0.12% (5.70%-6.13%). Cox's proportional regression analysis of DR incidence shows that renal function studied by eGFR < 60 ml/min/1.73 m2 was less significant (, HR 1.223, 1.098-1.201) than UACR ≥ 300 mg/g (, HR 1.485, 1.103-1.548). The study of STDR shows that eGFR < 60 ml/min/1.73 m2 was significant (, HR 1.890, 1.267-2.820), UACR ≥ 300 mg/g (, HR 2.448, 1.595-3.757), and DME shows that eGFR < 60 ml/min/1.73 m2 was significant (, HR 1.920, 1.287-2.864) and UACR ≥ 300 mg/g (, HR 2.432, 1.584-3.732). Conclusions. The UACR has a better association with diabetic retinopathy than the eGFR, although both are important risk factors for diabetic retinopathy.