Time-sequential correlations between diabetic kidney disease and diabetic retinopathy in type 2 diabetes – an 8-year prospective cohort study
Journal
Acta Ophthalmologica
Journal Volume
99
Journal Issue
1
Date Issued
2021-02-01
Author(s)
Hsieh, Ming Chia
Abstract
Purpose: To investigate the time-sequential correlations between progression/remission of diabetic kidney disease (DKD) and development of diabetic retinopathy (DR) or diabetic macular oedema (DME) in type 2 diabetes (T2D). Methods: This was an 8-year prospective cohort study in which 576 patients with T2D and microalbuminuria from one medical centre in Taiwan were recruited. Progression of microalbuminuria was defined as shift of urinary albumin/creatinine ratio (ACR) into 300 mg/g or more; remission of microalbuminuria was defined as having a urinary ACR less than 30 mg/g in at least two of three tests over a period of 6 months. Cox regression analysis was used to evaluate the hazard ratios (HRs) for progression or remission of microalbuminuria on development of any DR, proliferative DR (PDR) and DME. Results: After adjusting for baseline characteristics, remission of microalbuminuria was a significant protecting factor for development of PDR (HR = 0.290, 95% CI: 0.102–0.826, p = 0.020) and DME (HR = 0.404, 95% CI: 0.188–0.864, p = 0.020). After further adjustment for the mean follow-up HbA1c and systolic blood pressure, remission of microalbuminuria was still a significant protecting factor for development of PDR (HR = 0.348, 95% CI: 0.122–0.992, p = 0.048). Conclusions: Remission of microalbuminuria was an independent protecting factor for development of PDR and DME. Aggressive treatment for DKD might help prevent the progression of DR.
Subjects
diabetes mellitus | diabetic kidney disease | diabetic macular edema | diabetic retinopathy
SDGs
Type
journal article