To investigate the associations of renal function with diabetic retinopathy (DR) and diabetic macular oedema (DMO) in diabetic patients.
A total of 1877 diabetic participants aged 30 to 80 years were consecutively recruited between October 2017 and April 2019. The presence of DR, vision-threatening DR (VTDR) and DMO were graded using seven-field fundus photographs. Renal function was defined as normal, mildly impaired or indicative of chronic kidney disease (CKD) based on different estimated glomerular filtration rates (GFR).
In the multivariable logistic regression model, decreased GFR was associated with the presence of any DR only in the presence of microalbuminuria (OR = 2.40 for mildly impaired and 3.37 for CKD, all P < 0.05), while an impaired GFR was an independent risk factor for VTDR regardless of microalbuminuria status (all P < 0.05). The risks of any DR (OR = 1.74 for quartile 2 and 3.09 for quartile 4) and VTDR (OR = 3.27 for quartile 2 and 6.41 for quartile 4) increased gradually along with microalbuminuria quartile (all P < 0.05). CKD (OR = 3.07, P = 0.012) and high microalbuminuria (OR = 3.22 for quartile 3 and 5.25 for quartile 4, all P < 0.05) were independent DMO risk factors.
Conclusions and relevance
There is a strong association between GFR and VTDR, whereas the association between GFR and any DR was significant only under the premise of microalbuminuria. High microalbuminuria and CKD were significantly associated with DMO.
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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request
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This study was completed using data from Guangzhou Diabetic Eye Study in Zhongshan Ophthalmic Center. Thanks very much to all participants.
This study was funded by the National Natural Science Foundation of China (82171084; 82000901; 81900866), the Guangzhou Science & Technology Plan of Guangdong Pearl River Talents Program (202102010162), the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (303060202400362).
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Wang, L., Jin, L., Wang, W. et al. Association of renal function with diabetic retinopathy and macular oedema among Chinese patients with type 2 diabetes mellitus. Eye 37, 1538–1544 (2023). https://doi.org/10.1038/s41433-022-02173-5