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Diabetic retinopathy may help screen for CKD progression risk
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The risk for chronic kidney disease progression is relatively high in the United States, and the presence of diabetic retinopathy may be a valuable screening tool for adults with diabetes to determine those at high risk for progression, study data show.
Meda E. Pavkov, MD, PhD, of the division for diabetes translation of the CDC, and colleagues evaluated data from the National Health and Nutrition Examination Surveys (2005-2008) on 387 adults with diabetes and CKD, representing 4.9 million U.S. adults, to determine the prevalence of diabetic retinopathy and severe diabetic retinopathy among them.
The presence of one or more retinal microaneurysms or retinal blot hemorrhages with or without more severe lesions on fundus photographs was used to define diabetic retinopathy. The presence of severe nonproliferative diabetic retinopathy, proliferative diabetic retinopathy or clinically significant macular edema was used to define vision-threatening diabetic retinopathy.
Overall, diabetic retinopathy prevalence was 36.2% and vision-threatening diabetic retinopathy 8.2%.
Participants with diabetic retinopathy were older, had higher HbA1c and blood pressure, and longer diabetes duration, and they were more likely to be on insulin therapy compared with participants without diabetic retinopathy. The odds for diabetic retinopathy were 50% higher with each 1% increase in HbA1c, 40% higher for every additional 5 years of diabetes duration, 3% higher per 10 mm Hg increase in systolic BP and 13-fold higher with insulin treatment (OR = 13.3; 95% CI, 2.2-81.7) in a multivariable-adjusted model.
The researchers noted that the data represent 1.8 million U.S. adults at high risk for CKD progression and that most risk factors for diabetic retinopathy are modifiable. – by Amber Cox
Reference:
Pavkov ME, et al. Poster 1027. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 11-15, 2017; Lisbon, Portugal.
Disclosures: The authors report no relevant financial disclosures.