The following is a summary of “Diabetic Macular Edema Is Predictive of Renal Failure in Patients With Diabetes Mellitus and Chronic Kidney Disease,” published in the March 2024 issue of Endocrinology by Ou, et al.
The study focused on the relationship between diabetic macular edema (DME) and diabetic kidney disease (DKD) in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Chronic hyperglycemia in DM patients can lead to retinal damage and leakage, resulting in vision loss. While DR and DKD are often correlated, the association between DME and DKD was poorly understood. For a study, researchers sought to investigate whether the presence of DME can predict the development of renal failure, specifically end-stage renal disease (ESRD), in patients with DM and CKD.
The retrospective cohort study utilized data from 120 healthcare organizations in the TriNetX network, reviewing electronic medical records of approximately 90 million patients. Patients are classified into DME and non-DME cohorts. The primary outcome was new-onset ESRD, while the secondary outcome was all-cause mortality. Covariate factors were included to minimize confounding effects.
Before matching, the DME cohort showed higher medication use, poorer renal function, and worse blood sugar control compared to the non-DME cohort. However, after matching for demographics, socioeconomic status, lifestyle, comorbidities, and medication usage, the two groups are well-balanced. The DME cohort exhibited a significantly higher risk of ESRD, dialysis, and renal transplantation compared to the non-DME cohort. Subgroup analyses consistently showed the results regardless of follow-up duration, initial estimated glomerular filtration rate, or glycated hemoglobin levels. Additionally, the DME cohort had a lower risk of all-cause mortality than the non-DME cohort.
The study identified a statistically significant 5-year increased risk of ESRD, dialysis, and renal transplantation in patients with concurrent DME. Thus, close monitoring and follow-up of renal function in DM patients with DME were crucial and strongly recommended.
Reference: academic.oup.com/jcem/article-abstract/109/3/761/7296057