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The Relationship Between Renal and Retinal Disorder in Type 2 Diabetes

Researchers study retinopathy as possible indicator of nephropathy…

The number of diabetes mellitus cases is on the rise while the incidence of end-stage kidney disease from diabetes has decreased over the years. However, diabetes remains the main cause of end-stage kidney disease in the United States and other countries. There are different types of kidney disease that can occur in patients with disease such as diabetic nephropathy, but diabetic nephropathy is not the primary renal disease affecting patients with disease. There are other diseases such as non-diabetic renal disease, which, according to previous studies, is very different from diabetic nephropathy. However, there has not been a correlation established between nephropathy and retinopathy in type 2 diabetes patients with proteinuria.

The purpose of this study is to establish a correlation between nephropathy and retinopathy in type 2 diabetes patients with proteinuria. The study was conducted from October 2011 to September 2013. The diabetes patients who participated in the study attended the nephrology services. Their urine was screened for proteinuria using the dipstick method. The Fischer exact probability test and the Chi-square test were performed in the study to detect the statistical difference.

The results of the study showed that all patients with type 2 diabetes with renal disease do not appear to have classical diabetic nephropathy. The researchers observed that longer term duration of diabetes (>10 years) was the strongest indicator of diabetic nephropathy while diabetic patients having solely non-diabetic renal disease had a shorter duration of diabetes. Diabetic retinopathy was not present in 21/31 (67.7%) patients. This showed that retinal lesion is less common in type 2 diabetes in comparison to type 1 diabetes. Non-diabetic kidney disease was recorded in 40% of the cases in the presence of diabetic retinopathy and 43% of the cases had biopsy-proven diabetic nephropathy in the absence of diabetic retinopathy. This proves that diabetic retinopathy is not an indicator of nephropathy in patients with type 2 diabetes.

Practical Pearls:

  • Renal biopsy is ideal for diagnosis of diabetic and non-diabetic kidney disease.
  • There is no correlation between diabetic nephropathy and diabetic retinopathy in patients with type 2 diabetes.
  • Retinopathy is more common in patients with type 1 diabetes.

Prakash J, Gupta T, Prakash S, et al. “Non-diabetic renal disease in type 2 diabetes mellitus: Study of renal-retinal relationship.” Indian J Nephrol. 2015;25(4):222-8.