J Clin Endocrinol Metab. 2023 Oct 6:dgad581. doi: 10.1210/clinem/dgad581. Online ahead of print.
ABSTRACT
CONTEXT: Chronic hyperglycaemia in patients with diabetes mellitus (DM) causes retinal damage and leakage, resulting in vision loss. Although diabetic retinopathy (DR) and diabetic kidney disease (DKD) are usually correlated, the relationship between diabetic macular oedema (DME) and DKD remains unknown.
OBJECTIVE: To assess whether DME presence can predict renal failure in patients with DM and chronic kidney disease (CKD).
DESIGN: This retrospective cohort study used data from the TriNetX network.
SETTING: One-hundred and twenty healthcare organisations.
PATIENTS: Electronic medical records of approximately 90 million patients were reviewed. The study population was classified into DME and non-DME cohorts.
MAIN OUTCOME MEASURES: Primary and secondary outcomes were new-onset end-stage renal disease (ESRD) and all-cause mortality, respectively. Covariate factors were incorporated to reduce confounding effects.
RESULTS: Before matching, the DME cohort used more medication and had poorer renal function and blood sugar control than the non-DME cohort. Subsequently, the two groups were well-matched in demographics, socioeconomic status, lifestyle, comorbidities, and medication usage. The DME cohort had a significantly higher risk of ESRD, dialysis, and renal transplantation than the non-DME cohort. Subgroup analyses showed consistent results irrespective of follow-up duration, initial estimated glomerular filtration rate, or glycated haemoglobin levels. Additionally, the DME cohort had a lower risk of all-cause mortality than the non-DME cohort.
CONCLUSIONS: Statistically significant 5-year increased risks of ESRD, dialysis, and renal transplantation were observed in patients with concurrent DME. Therefore, close monitoring and follow-up of the renal function in DM patients with DME are necessary and strongly recommended.
PMID:37804118 | DOI:10.1210/clinem/dgad581
