The association of retinopathy and low GFR in type 2 diabetes.

Kleins Lab // Publications // Dec 01 2012

PubMed ID: 23068959

Author(s): Mottl AK, Kwon KS, Garg S, Mayer-Davis EJ, Klein R, Kshirsagar AV. The association of retinopathy and low GFR in type 2 diabetes. Diabetes Res Clin Pract. 2012 Dec;98(3):487-93. doi: 10.1016/j.diabres.2012.09.041. Epub 2012 Oct 12. PMID 23068959

Journal: Diabetes Research And Clinical Practice, Volume 98, Issue 3, Dec 2012

AIMS We sought to determine characteristics which strengthen the association between markers of diabetic kidney disease and retinopathy.

METHODS Multivariate regression analyses of NHANES 2005-2008 assessed the association of retinopathy with renal insufficiency and albuminuria. Analyses were stratified to evaluate ethnicity/race, obesity, and use of renin-angiotensin-aldosterone system antagonists as effect modifiers of this relationship.

RESULTS Of 269 participants with renal insufficiency, 35% had no microalbuminuria and no retinopathy; 16.1% had retinopathy with no microalbuminuria; 27.1% had microalbuminuria and no retinopathy and 22% had both microalbuminuria and retinopathy. Stratified, multivariate logistic regression analyses demonstrated retinopathy to be significantly predictive of renal insufficiency only in nonHispanic Blacks (OR=2.7; 95% CI 1.2, 6.1), obesity (OR=2.6; 95% CI 1.3, 5.5) and in those participants not using renin-angiotensin-aldosterone blockers (OR=2.5; 95% CI 1.1, 5.7). Analyses showed an independent relationship between retinopathy and albuminuria only when albuminuria was modeled continuously.

CONCLUSIONS In older onset diabetes, the absence of albuminuria and retinopathy is common among individuals with renal insufficiency. The relationship between microvascular complications of the eye and kidney may vary according to ethnicity, obesity and use of renin-angiotensin-aldosterone antagonists. These findings need to be confirmed in other large, diverse cohorts.

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