Diabetic retinopathy: a new predictor in patients on regular hemodialysis

El‐Menyar, Ayman; Thani, Hassan Al; Hussein, Ahmed; Sadek, Ahmed; Sharaf, Ahmed; Suwaidi, Jassim Al

doi:10.1185/03007995.2012.684675

Cited by 8 publications

(9 citation statements)

References 29 publications

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“…The results of the multivariate analysis showed that the risk of foot ulceration was independently associated with DR and the presence of stenosing carotid plaques and that amputations were also independently associated with DR. The prevalence of DR among type 2 DM patients in haemodialysis has been previously reported to be between 70% and 79% [ 8 , 20 ], which is only slightly higher than the 63% observed in our study. This is in line with the results of a retrospective study where the incidence of retinopathy was found to be significantly higher among subjects in haemodialysis who had a foot ulcer than that among those who did not (88% versus 54%) [ 21 ] and also with a recent meta-analysis that identified retinopathy as a risk factor for foot ulceration in adults with ESRD treated with dialysis [ 22 ].…”

Section: Discussioncontrasting

confidence: 85%

Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Dòria

Rosado

Pacheco

et al. 2016

BioMed Research International

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Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p = 0.004 and p = 0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p = 0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.

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Section: Discussioncontrasting

confidence: 85%

Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Dòria

Rosado

Pacheco

et al. 2016

BioMed Research International

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“…Therefore, it is clearly seen that in many countries, the incidence of both DM and MVC is increasing exponentially which poses a great challenge for healthcare authorities and resources. [ 8 78 79 80 ]…”

Section: Discussionmentioning

confidence: 99%

Traumatic injuries in patients with diabetes mellitus

El‐Menyar

Mekkodathil²,

Al-Thani³

2016

J Emerg Trauma Shock

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Diabetes mellitus (DM) is associated with increased in-hospital morbidity and mortality in patients sustained traumatic injuries. Identification of risk factors of traumatic injuries that lead to hospital admissions and death in DM patients is crucial to set effective preventive strategies. We aimed to conduct a traditional narrative literature review to describe the role of hypoglycemia as a risk factor of driving and fall-related traumatic injuries. DM poses significant burden as a risk factor and predictor of worse outcomes in traumatic injuries. Although there is no consensus on the impact and clear hazards of hyperglycemia in comparison to the hypoglycemia, both extremes of DM need to be carefully addressed and taken into consideration for proper management. Moreover, physicians, patients, and concerned authorities should be aware of all these potential hazards to share and establish the right management plans.

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“…This is consistent with a recent study among patients with hemodialysis that found a significant correlation between diabetic retinopathy and peripheral arterial disease. 18 There are several limitations to this study. The study population was restricted to inpatients at UPMC Mercy Hospital in Pittsburgh, an inner city community teaching hospital.…”

Section: Stage N Prevalence (%)mentioning

confidence: 94%

“…10 After examining factors associated with diabetic retinopathy, duration of diabetes and history of renal disease were each found to be independently predictive of diabetic retinopathy in the inpatient population, which is consistent with previous studies. 17 18 Although microalbuminuria has been shown to be a risk factor for retinopathy in patients with type 1 diabetes but not type 2 Figure 1 Barriers to diabetic retinopathy screening examinations as reported by those patients who did not have dilated fundus examinations in the previous year. DR, diabetic retinopathy.…”

Section: Stage N Prevalence (%)mentioning

confidence: 99%

Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)

Kovarík

Eller

Willard

et al. 2016

BMJ Open Diab Res Care

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Objective To determine the prevalence and risk factors of diabetic retinopathy in the inpatient diabetic population in the USA and to determine the barriers to ophthalmic examinations and treatment among this population. Research design and methods A cross-sectional analysis of 113 inpatients with diabetes mellitus admitted to an inner city community teaching hospital in Pittsburgh. Digital fundus photographs of the posterior pole were taken of each eye after pharmacological dilation. Presence, absence and severity of diabetic retinopathy and macular edema were graded on the basis of internationally accepted criteria. An investigator-administered questionnaire and review of the medical record were used to obtain data about patient demographics, clinical characteristics and barriers to ophthalmic care. The association between these data and the presence of diabetic retinopathy was tested. Results The estimated prevalence of diabetic retinopathy in the inpatient population was 44% (95% CI 34% to 53%). The prevalence of previously undiagnosed diabetic retinopathy and sight-threatening retinopathy was 25% (95% CI 17% to 33%) and 19% (95% CI 11% to 26%), respectively. Renal disease was independently associated with the presence of diabetic retinopathy (OR, 3.86; 95% CI 1.22 to 12.27), as well as a longer duration of diabetes (OR, 1.08 per year; 95% CI 1.014 to 1.147). Diabetic retinopathy was seen in 15 of 17 patients admitted with diabetic foot ulcers or osteomyelitis. Frequently reported barriers to ophthalmic examinations included lack of transportation and physical disability. Conclusions The prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in the inpatient population is likely significantly higher than in the general diabetic population in the USA. These patients have barriers to care that need to be addressed to make standard of care ophthalmic examinations and treatment possible in this population.

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Diabetic retinopathy: a new predictor in patients on regular hemodialysis

Cited by 8 publications

References 29 publications

Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Traumatic injuries in patients with diabetes mellitus

Prevalence of undiagnosed diabetic retinopathy among inpatients with diabetes: the diabetic retinopathy inpatient study (DRIPS)

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