The coexistence of diabetic retinopathy and diabetic nephropathy is associated with worse kidney outcomes.

Background

Up to 50-60% of patients with diabetes have non-diabetic kidney disease (NDKD) on kidney biopsy. Diabetic retinopathy (DR) is a microvascular complication of diabetes frequently associated with diabetic nephropathy (DN). The objective of the current study was to investigate the kidney outcomes and survival in patients with biopsy diagnoses of DN and NDKD according to the presence of DR.

Methods

We conducted an observational, multicentre and retrospective study of the pathological findings of renal biopsies from 832 consecutive patients with diabetes from 2002 to 2014 from 18 nephrology departments. The association of DR with kidney replacement therapy (KRT) or survival was assessed by Kaplan-Meier and Cox regression analyses.

Results

Of 832 patients with diabetes and renal biopsy, 768 had a retinal examination and 221/768 (22.6%) had DR. During a follow-up of 10 years, 288/760 (37.9%) patients with follow-up data needed KRT and 157/760 (20.7%) died. The incidence of KRT was higher among patients with DN (alone or with NDKD) and DR [103/175 (58.9%)] than among patients without DR [88/216 (40.7%),

Conclusions

DR is associated with a higher risk of progression to kidney failure in patients with histological DN and in patients with NDKD.

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.

Déclaration de conflit d'intérêts

S.B. reports honorarium for conferences, consulting fees and advisory boards from AstraZeneca, Boehringer, Bayer and Mundipharma. M.J.S. reports personal fees from Novo Nordisk, Jansen, Mundipharma, AstraZeneca, Esteve, Fresenius, Ingelheim Lilly, Vifor, ICU, Pfizer, Bayer, Travere Therapeutics and GE Healthcare and grants and personal fees from Boehringer Ingelheim, outside the current study. N.M. reports honoraria from Alexion and GSK. N.G.-F. paticipates on scientific advisory virtual of Mundipharma, honoraria for lectures of Astellas and medical Statistics Consulting and payment for expert testimony of Baxter, Viforpharma and Fresenius. B.F.-F. has received grants from Esteve and Astrazeneca and have worked for Cátedra UAM-mundipharma. B.F.-F. has received consultancy or speaker fees or travel support from Astrazeneca, Bayer, Menarini, Novo-Nordisk BoeringerInheilm and Mundipharma. B.F.F is Editor for Nefroplus. B.F.-F. has received travel support from Astrazeneca, Bayer, Menarini, Novo-Nordisk BoeringerInheilm and Mundipharma. B.F.-F. has been advisor for Astrazeneca, Bayer, Menarini, Novo-Nordisk Boeringer Inheilm and Mundipharma. M.P. reports consulting fees and payment for honoraria from Alexion, Novartis, Otsuka, Vifor, GSK, Travere. M.J.S. is Editor Emeritus of CKJ. The rest of authors have no conflicts of interest to declare.