Rate and determinants of association, between advanced retinopathy and chronic kidney disease in patients with type 2 diabetes: The renal insufficiency and cardiovascular events (RIACE) Italian multicenter study

Giuseppe Penno, Anna Solini, Giacomo Zoppini, Emanuela Orsi, Gianpaolo Zerbini, Roberto Trevisan, Gabriella Gruden, Franco Cavalot, Luigi Laviola, Susanna Morano, Antonio Nicolucci, Giuseppe Pugliese

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE - To evaluate the rate and determinants of concordance between advanced diabetic retinopathy (DR) and chronic kidney disease (CKD), as assessed by both albuminuria and estimated glomerular fi ltration rate (eGFR), in the large cohort of the Renal Insuf ficiency And Cardiovascular Events (RIACE) Italian multicenter study. RESEARCH DESIGN AND METHODS - Patients with type 2 diabetes (n = 15,773) visiting consecutively 19 hospital -based diabetes clinics in years 2007 and 2008 were examined. DR was assessed by dilated fundoscopy. CKD was de fined based on albuminuria and eGFR. RESULTS - CKD was present in 58.64%of subjects with advanced DR, whereas advanced DR was detectable only in 15.28%of individuals with any CKD and correlated with the albuminuric CKD phenotypes more than with the nonalbuminuric phenotype. Age, male sex, diabetes duration, hemoglobin A 1c, hypertension, triglycerides, previous cardiovascular disease, and, inversely, HDL-cholesterol correlated independently with the presence of any CKD in individuals with advanced DR; correlates differed according to the presence of albuminuria, reduced eGFR, or both. Conversely, factors associated with the presence of advanced DR in subjects with any CKD were diabetes treatment, previous cardiovascular disease, albuminuria, and, inversely, smoking, eGFR, and age at diagnosis. CONCLUSIONS - Concordance of CKD with advanced DR is low in subjects with type 2 diabetes, and CKD without advanced DR ismore frequent than isolated advanced DR, at variance with type 1 diabetes. Factors independently associated with the presence of any CKD in individuals with advanced DR differ, at least in part, from those correlating with the presence of advanced DR in subjects with any CKD and by CKD phenotype.

Original languageEnglish
Pages (from-to)2317-2323
Number of pages7
JournalDiabetes Care
Volume35
Issue number11
DOIs
Publication statusPublished - Nov 2012

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

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