Evaluation of renal function in type 2 diabetes mellitus patients with diabetic retinopathy at SekuruKaguvi Eye Hospital

Abstract

Background: Diabetic Retinopathy (DR) and diabetic nephropathy are the leading causes of blindness and chronic kidney disease worldwide respectively and the most significant long-term complications in terms of morbidity and mortality in patients with diabetes.
Objective: To determine the prevalence of renal failure in type 2 diabetic patients presenting with diabetic retinopathy at Sekuru Kaguvi Eye Hospital out-patients department.
Study Design: Hospital based cross sectional.
Setting: Sekuru Kaguvi Hospital (SKH) out-patients unit.
Materials and Methods: Convenience sampling, whereby patients coming to the outpatients department with type 2 diabetic retinopathy were enrolled into the study from June 2017 to May 2018. All participants had their medical history taken guided by an interviewer administered questionnaire. Fundus examination including general eye examination was done to stage the retinopathy whilst urine and blood samples were taken to evaluate proteinuria and estimated glomerular filtration rate respectively.
Results: One hundred and seventy diabetic patients with retinopathy were evaluated. The prevalence of proteinuria in diabetics with retinopathy was found to be 62.9%. The prevalence of impaired renal function amongst patients with diabetic retinopathy attending SKH was 46.5%. Diabetic retinopathy worsens with worsening of diabetic nephropathy such that it is 40 times more common to find impaired renal function in advanced diabetic retinopathy than it is in very mild non-proliferative diabetic retinopathy (95% CI, p=0.000).
Conclusion: The high prevalence of renal impairment in type 2 Diabetes mellitus (DM) patients presenting with diabetic retinopathy calls for the need to strengthen screening of diabetic patients for both retinopathy and renal impairment to facilitate early treatment and reduce the morbidity and mortality associated with these complications.