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Time‐sequential correlations between diabetic kidney disease and diabetic retinopathy in type 2 diabetes – an 8‐year prospective cohort study
Author(s) -
Hsieh YiTing,
Hsieh MingChia
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14487
Subject(s) - microalbuminuria , medicine , diabetic retinopathy , type 2 diabetes , hazard ratio , prospective cohort study , kidney disease , albuminuria , creatinine , diabetes mellitus , proportional hazards model , risk factor , urology , blood pressure , gastroenterology , endocrinology , confidence interval
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.