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논문분류	춘계학술대회 초록집
제목	Diabetic Retinopathy is a Prognostic Factor for Progression of Chronic Kidney Disease in the Patients with Type 2 Diabetes Mellitus
저자	Kyu Sang Yun, Hayne Cho Park, A Jin Cho, Do Hyoung Kim, Ju Hee Kim, Young Joo Shin, So Hyun Bae, Ha Kyoung Kim, Young Ki Lee
출판정보	2020; 2020(1):
키워드	Diabetic Retinopathy \| Glomerular Filtration rate \| Albuminuria \| Chronic Kidney Disease \| Diabetes Mellitus, Type2
초록	Although both retinopathy and nephropathy are major diabetic microvascular complications, a few studies have examined the relationship between retinal structural changes and renal functions in patients with diabetes. Therefore, we investigated whether severity of diabetic retinopathy (DR) has adverse effects on renal function and albuminuria in the patients with type 2 diabetes mellitus (DM). We screened 2,197 adult patients with type 2 DM who had undergone fundus exam between August 2006 and February 2014. Among them, 1,602 subjects with available serial renal function and albuminuria measurement were included in the analysis. DR status was classified as no DR, non-proliferative DR (NPDR), and proliferative DR (PDR). The risk of renal function decline and albuminuria progression was assessed according to DR severity. A total of 387 (24.2%) patients had NPDR and 204 (12.7%) had PDR at either eye. The mean follow-up period was 5.6±2.1 years. DR was associated with lower body mass index, lower plasma hemoglobin, lower serum albumin level, longer duration of DM, poorer control of blood sugar, lower estimated glomerular filtration rate (eGFR), and greater amount of albuminuria. During mean follow-up duration of 5.6±2.1 years, baseline DR severity was associated with faster renal function decline (Figure 1). In multivariate analysis, NPDR had 2.3 times and PDR had 5.5 times higher risk for CKD progression (Table 1). Our findings demonstrated that baseline DR severity is a prognostic factor for future CKD progression in type 2 DM patients. Therefore, clinicians must evaluate DR severity at the first visit and closely monitor renal function and albuminuria in the subjects with severe DR.
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