Progression of Diabetic Retinopathy and Declining Renal Function in Patients with Type 2 Diabetes

Background. At a university hospital in Korea, we conducted a retrospective study to determine the association of the progression of diabetic retinopathy (DR) with declining renal function in type 2 diabetes. Methods. We included a total of 1527 patients with type 2 diabetes who followed up in our diabetes clinic and underwent fundus photographic examinations from August 2006 to February 2014. DR was assessed by retinal ophthalmologists using comprehensive ophthalmologic examinations. Results. The baseline prevalence of nonproliferative DR (NPDR) and proliferative DR (PDR) was 26.5% and 14.7%, respectively. Among 1303 patients with no DR and NPDR, 134 (10.3%) patients progressed to NPDR or PDR. The progression group had longer duration of diabetes, higher fasting plasma glucose, higher HbA1c, and a higher rate of ≥20% decline in eGFR during the follow-up period. After multivariate analysis, ≥20% decline in eGFR (odds ratio 2.553, 95% CI 1.219-5.348, p=0.013) was an independent risk factor for progression of DR in patients with NPDR. Conclusion. Declining renal function was independently associated with DR progression in patients with NPDR, suggesting that investigation of DR status should be recommended for patients with declining renal function