Diabetic retinopathy and its association with low glomerular filtration rate: a cross-sectional analysis of diabetes pat
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ORIGINAL ARTICLE
Diabetic retinopathy and its association with low glomerular filtration rate: a cross-sectional analysis of diabetes patients of community clinics across India Kalpana Dash 1 & Aftab Ahmed 2 & Sambit Das 3 & Balaji Jaganmohan 4 & Surekha Tippisetty 2 & Vamsi Krishna Kolukula 2 & Krishna G. Seshadri 5 & Apollo Sugar Research Group Received: 18 January 2019 / Accepted: 1 October 2019 # Research Society for Study of Diabetes in India 2020
Abstract Aims To determine the prevalence of diabetic retinopathy (DR) in patients with T2DM having low estimated glomerular filtration rate (eGFR). Methods A cross-sectional retrospective data analysis of T2DM patients’ records who were screened for DR across Apollo Sugar Clinics from June 2016 to December 2016. DR was diagnosed through fundus examination; patients having eGFR values were grouped into eGFR < 60 and eGFR ≥ 60 mg/ml/1.73 m2. Appropriate statistical tests were applied to identify the association of eGFR and DR, and significance was set at 2-tailed p ≤ 0.05. Results A total of 1547 T2DM patients were screened; mean (SD) age was 56.7 (10.0) years. Among them, data of 443 patients with eGFR were included in the analysis. Mean eGFR was 91.2 mg/ml/1.73 m2; 12.5% patients had eGFR ≤ 60 mg/ml/1.73 m2 and 87.5% had ≥ 60 mg/ml/1.73 m2. DR was observed in 79 (17.8%) patients; it was higher in males (62%) than in females (38%). Further, the proportion of patients with DR was significantly higher in patients with eGFR ≤ 60 mg/ml/1.73 m2 compared with that in patients with eGFR ≥ 60 mg/ml/1.73 m2 (38% vs. 15%; p < 0.001). Conclusion Association of DR with low eGFR in patients with T2DM may suggest presence of diabetes kidney disease in a community, thus reaffirming the significance of DR screening in community diabetes practices. Keywords Diabetes . Eye . Complications . Glomerular filtration rate . Kidney . Retinopathy
Introduction Diabetes mellitus, a global chronic disorder, affected 9.3% of South-East Asian adult population (20–79 years), a report by International Diabetes Federation (IDF) 2015, which is equivalent to 153 million people living with diabetes [1]. It is a condition that flags way for many complications if left untreated or if treatment is not appropriate. Type 2 diabetes mellitus (T2DM) and associated eye complications are a complex * Krishna G. Seshadri [email protected] 1
Apollo Sugar Clinic, Raipur, India
2
Apollo Sugar Clinic, Secunderabad, India
3
Apollo Sugar Clinic, Apollo Hospital, Bhubaneswar, India
4
Apollo Sugar Clinic, Padmanabhanagar, Bangalore, India
5
Apollo Sugar Clinic, Apollo Hospital, Greams Road, Chennai, India
condition with multi-factorial etiology, where inherent genetic factors and triggering environmental factors play an active role [2]. Majority of the diabetes patients develop micro- or/ and macrovascular complications with the increasing age, duration of disease, and poor glycemic control [3]. Diabetic retinopathy (DR) is one among the microvascular complications that contribute to other diabete
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