Early nephropathy predicts vision-threatening retinal disease in patients with type I diabetes mellitus.

Journal of the American Society of Nephrology : JASN
R E GilbertG Jerums

Abstract

In type I (insulin-dependent) diabetes mellitus, nephropathy may be identified in its early stages by the development of persistent microalbuminuria. This longitudinal study sought to examine the development of vision-threatening retinal disease (VTRD) (proliferative retinopathy and clinically significant macular edema) in such patients with early and evolving diabetic kidney disease. Eighty patients with type I diabetes and at least 8 yr of longitudinal data were identified. Glycated hemoglobin and albumin excretion rate (AER) were measured every 3 mo. Ophthalmologic examination was performed at least yearly. Thirteen patients were identified as having evolving nephropathy by a progressive increase in AER and the presence of microalbuminuria during the study period. Sixty-seven patients remained persistently normoalbuminuric. VTRD developed in eight of 13 (62%) patients with evolving nephropathy compared with five of 69 (7%) patients who were persistently normoalbuminuric (P < 0.001) in the absence of any difference in long-term glycemic control or duration of diabetes between the two groups. Clinically significant macular edema (P < 0.05) and proliferative retinopathy (P < 0.01) were both more common in patients with evolving...Continue Reading

Citations

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