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Overt Proteinuria, Moderately Reduced eGFR and Their Combination Are Predictive of Severe Diabetic Retinopathy or Diabetic Macular Edema in Diabetes
- Source :
- Investigative Opthalmology & Visual Science. 60:2685
- Publication Year :
- 2019
- Publisher :
- Association for Research in Vision and Ophthalmology (ARVO), 2019.
-
Abstract
- Purpose Since the combined effects of proteinuria and a moderately decreased eGFR on incident severe eye complications in patients with diabetes are still largely unknown, these associations were determined in a large historical cohort of Japanese patients with diabetes mellitus. Methods We evaluated the effects of overt proteinuria (OP) (dipstick 1+ and over) and/or moderately reduced estimated glomerular filtration rate (eGFR) (MG) (baseline eGFR 30.0-54.9 mL/min/1.73 m2) on the incidence of treatment-required diabetic eye diseases (TRDED). We divided 7709 patients into four groups according to the presence or absence of OP and MG: no OP without MG (NP[MG-]), OP without MG (OP[MG-]), no OP with MG (NP[MG+]), and OP with MG (OP[MG+]). Multivariate Cox analyses were performed to calculate hazard ratios (HRs) with 95% confidence intervals for combinations of the presence and/or absence of OP and MG on the risk of developing TRDED. Results During the median follow-up period of 5.6 years, 168 patients developed TRDED. HRs for OP and MG for incident TRDED were 1.91 (95% confidence interval, 1.27-2.87) and 1.90 (1.11-3.23), respectively. HRs for incident TRDED were 1.73 (1.11-2.69) and 5.57 (2.40-12.94) for OP(MG-) and OP(MG+), respectively, in comparison with NP(MG-). Conclusions In Japanese patients with diabetes, OP and MG were separately as well as additionally associated with higher risks of TRDED. Results indicate the necessity of the simultaneous assessment of proteinuria and eGFR for appropriate evaluation of risks of severe eye complications in patients with diabetes.
- Subjects :
- Adult
Blood Glucose
Male
medicine.medical_specialty
Renal function
Gastroenterology
Macular Edema
Young Adult
Internal medicine
Diabetes mellitus
medicine
Humans
Renal Insufficiency, Chronic
Aged
Proportional Hazards Models
Glycated Hemoglobin
Diabetic Retinopathy
Proteinuria
business.industry
Proportional hazards model
Incidence
Incidence (epidemiology)
Hazard ratio
Diabetic retinopathy
Middle Aged
medicine.disease
Confidence interval
Diabetes Mellitus, Type 2
Female
medicine.symptom
business
Follow-Up Studies
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 15525783
- Volume :
- 60
- Database :
- OpenAIRE
- Journal :
- Investigative Opthalmology & Visual Science
- Accession number :
- edsair.doi.dedup.....12304b3c36bf66e14fdc0165ce23fdd2