Diabetic kidney disease and diabetic retinopathy: the ominous duo
- PDF / 130,137 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 62 Downloads / 200 Views
EDITORIAL
Diabetic kidney disease and diabetic retinopathy: the ominous duo Vijay Viswanathan 1
# Research Society for Study of Diabetes in India 2020
Diabetic kidney disease (DKD) and diabetic retinopathy (DR) are two feared complications of diabetes. The article by Dash et al., in this journal, “Diabetic retinopathy and its association with low glomerular filtration rate: a cross sectional analysis of diabetes patients of community clinics across India”, looks at the association between these two microvascular complications [1]. In this retrospective study of 1547 people with type 2 diabetes mellitus (T2DM), they looked at the association between DKD and DR in 443 people. The prevalence of DR was found to be more in people with lower estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m2. There was also a significant correlation between low levels of eGFR and DR [1]. The expenditures on hospitalisation for people with diabetes and DKD in India are considerably higher than in those without any complication [2]. In a 12-year observational study in India, Viswanathan et al. found that among 152 people who had normoalbuminuria at baseline, the presence of diabetic retinopathy showed a significant association with the development of macroalbuminuria [3]. In another study by the author, comparing people with proteinuria and those without proteinuria, it was observed that diabetic retinopathy was present in 100% of proteinuric patients vs 24% in the nonproteinuric group [4]. The author also studied the renal-retinal relationship in people with T2DM in India [5]. The mean decline in renal function worsened significantly as the severity of DR increased. The mortality rate was higher in people with both DKD and DR. In a recent study done in a tertiary care diabetes centre in South India, the effect of DKD on the development of newonset DR and sight-threatening diabetic retinopathy (STDR)
* Vijay Viswanathan [email protected] 1
Prof M Viswanathan Diabetes Research Centre, Chennai, India
was studied [6]. Higher serum creatinine, low eGFR and the presence of macroalbuminuria were associated with increased risk of progression to STDR [6]. From the above-mentioned discussion, it is very evident that in people with DM, the presence of DR is associated with worsening kidney function. It is also seen that in people with declining kidney function, the risk of severe DR is also increased. The relationship between the degree of diabetic retinopathy and the severity of glomerular lesions in people with T2DM may not always show concordance. Discordance between DKD and DR occurs often. Some people with DR do not have any evidence of DKD. Discordance between these two conditions is believed to be due to some differences in the pathogenesis of these two conditions. A recent population-based study on multi-ethnic Asian adults found that those patients with concordance of both DKD and DR had a higher risk of all-cause and CV mortality [7]. The general concept is that all people with DKD will exhibit some degre
Data Loading...
