Relationship between albuminuric CKD and diabetic retinopathy in a real-world setting of type 2 diabetes: Findings from No blind study.

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    • Corporate Authors:
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9111474 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1590-3729 (Electronic) Linking ISSN: 09394753 NLM ISO Abbreviation: Nutr Metab Cardiovasc Dis Subsets: MEDLINE
    • Publication Information:
      Publication: 2005- : Amsterdam : Elsevier
      Original Publication: [Heidelberg] : Springer International, c1991-
    • Subject Terms:
    • Abstract:
      Background and Aims: Recently, the albuminocentric view of diabetic kidney disease (DKD) in type 2 diabetes (T2DM) has been changing. Therefore, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) has to be addressed according to this new clinical presentation of DKD. The aim of this study was to evaluate, in a real-world setting, the correlation DR-DKD in T2DM.
      Methods and Results: A total of 2068 type 2 diabetic patients enrolled in a multicenter cross-sectional study were investigated. Albuminuric subjects were largely prevalent among subjects with DR (p = 0.019). In the whole study population, no difference in albumin excretion rate (AER) was observed between presence/absence of DR; instead, AER was significantly higher among patients with glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 (CKD) (p = 0.009), above all in those with CKD and AER ≥0.03 g/24 h (p = 0.005). Multivariate analysis confirmed that eGFR (O.R. 0.976; 95% C.I.: 0.960-1.028; p < 0.001) and AER (O.R. 1.249; 95% C.I. 1.001-1.619; p = 0.004) were independently associated with DR and HDL-cholesterol (O.R.: 1.042; 95% C.I.: 1.011-1.120; p = 0.014). Additionally, among patients with eGFR <60 mL/min/1.73 m 2 and albuminuria, both eGFR and AER significantly varied between those with/without DR (p = 0.012 and p = 0.005, respectively), and this finding was observed among only albuminuric patients. Analogous results were obtained considering DR classification. AER was significantly higher among subjects with either proliferative DR (PDR) or severe nonproliferative DR (NPDR), with regard to mild NPDR (0.498 and 0.938 g/die vs. 0.101 g/die; p < 0.001, respectively). Similar results were obtained in the specular subgroups.
      Conclusion: In T2DM with DKD, the AER seems to be related to the presence of DR. This association is confirmed above all in those with more severe DR.
      (Copyright © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Investigator: D Giugliano, Diabetology Complex Operative Unit (C.O.U.) of the A.O.U. of University of Campania, Italy.; MI Maiorino, Diabetology Complex Operative Unit (C.O.U.) of the A.O.U. of University of Campania, Italy.; G Riccardi, Diabetology Complex Operative Unit (C.O.U.) of University of Naples Federico II, Italy.; L Bozzetto, Diabetology Complex Operative Unit (C.O.U.) of University of Naples Federico II, Italy.; V Guardasole, Internal Medicine Complex Operative Unit (C.O.U.) of University of Naples Federico II, Italy.; R Di Palo, ASL Napoli 1, Italy.; O Carbonara, ASL Napoli 2, Italy.; M Riccio, ASL Napoli 2, Italy.; G De Simone, ASL Napoli 3, Italy.; L Lucibelli, ASL Napoli 3, Italy.; S Masi, ASL Salerno, Italy.
      Keywords: Albumin excretion rate; Diabetic kidney disease; Diabetic retinopathy; Glomerular filtration rate
    • Publication Date:
      Date Created: 20190805 Date Completed: 20200302 Latest Revision: 20200302
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.numecd.2019.05.065
    • Accession Number:
      31377186