Estudio de relación entre microalbuminuria y retinopatía diabética en la diabetes mellitus tipo 1

Aroca, Pere Romero; Sentís, O. Espeso; Aure, P. Sardá; Déjardin, Daniel del Castillo

doi:10.1016/s0014-2565(00)70660-6

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Similarly, diabetic nephropathy is a complicating factor for DR and DME, which has been investigated in a few studies but with contrasting conclusions drawn by the respective authors. For example, studies using proteinuria as a marker of renal disease failed to associate DME and renal pathology [ 25 ] while a study based on data from a German/Austrian database found that macroalbuminuria increased the risk of DME by 177% [ 26 ]. Because of these differences in results using albuminuria as a marker, we chose GFR as a marker of renal failure (using the CKD–EPI formula [ 27 ]).…”

Section: Discussionmentioning

confidence: 99%

Does HbA1c Level or Glomerular Filtration Rate Affect the Clinical Response to Endothelial Growth Factor Therapy (Ranibizumab or Aflibercept) in Diabetic Macular Edema? A Real-Life Experience

Debourdeau,

Medard,

Chamard

et al. 2023

Ophthalmol Ther

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Introduction Anti-vascular endothelial growth factor (VEGF) therapy is the first-line treatment for diabetic macular edema (DME). We investigated the effect of initial glycosylated hemoglobin (HbA1c) level and glomerular filtration rate (GFR) on treatment outcomes in patients with DME receiving anti-VEGF injections in routine clinical practice. Methods A retrospective analysis of data from the prospective, multi-center, observational Fight Retinal Blindness! registry was performed. A total of 178 eyes with DME treated with anti-VEGF agents (ranibizumab or aflibercept) from 1 January 2010 to 31 March 2019 were enrolled in the analysis, with the long study period to allow for up to 24 months of follow-up. Data for eyes were tracked in the Fight Retinal Blindness! registry, and clinical parameters were collected by using local software. Changes in visual (best-corrected visual acuity [BCVA], in letters) and anatomic outcomes (central subfield thickness [CST], in microns) between subgroups of patients according to baseline HbA1c level (≤ 7% vs. > 7%) and GFR (> vs. ≤ 60 ml/min/m 2 at 24 months were assessed. Results The multivariate adjusted mean improvement in BCVA at 24 months of treatment was + 5.2 and + 6.8 letters in subgroups with baseline HbA1c level ≤ 7% and > 7%, respectively ( p = 0.541), and + 6.9 and + 6.4 letters in subgroups with GFR > 60 and < 60 ml/min/1.73 m 2 , respectively ( p = 0.852). The multivariate adjusted mean CST reduction was − 89.9 and − 76.4 µm in subgroups with baseline HbA1c level ≤ 7% and > 7%, respectively ( p = 0.505), and − 85 and − 115 µm in subgroups with baseline GFR > 60 and ≤ 60 ml/min/1.73 m 2 , respectively ( p = 0.130). Conclusion These results seem to indicate that visual and anatomical improvement in patients receiving intravitreal VEGF inhibitors for DME are independent of baseline HbA1c level and GFR, leading to the conclusion that high HbA1c levels or low GFR should not dictate injection timing in routine clinical practice. This study offers valuable insights for ophthalmologists, enabling a personalized treatment approach and optimizing DME patient outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-023-00758-1.

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Section: Discussionmentioning

confidence: 99%

Does HbA1c Level or Glomerular Filtration Rate Affect the Clinical Response to Endothelial Growth Factor Therapy (Ranibizumab or Aflibercept) in Diabetic Macular Edema? A Real-Life Experience

Debourdeau,

Medard,

Chamard

et al. 2023

Ophthalmol Ther

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Relationship between diabetic retinopathy, microalbuminuria and overt nephropathy, and twenty-year incidence follow-up of a sample of type 1 diabetic patients

Romero-Aroca

Baget-Bernaldiz

Reyes-Torres

et al. 2012

Journal of Diabetes and its Complications

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Review of the Relationship between Renal and Retinal Microangiopathy in Diabetes Mellitus Patients

Romero-Aroca

Méndez-Marín²,

Baget-Bernaldiz³

et al. 2010

CDR

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Diabetes mellitus is a group of metabolic disorders of carbohydrate metabolism in which glucose is underutilized, producing hyperglycemia. The latter complications of diabetes mellitus include microvascular complications the major microvascular complications, retinopathy and nephropathy, are the more important causes of blindness and end-stage renal disease in Europe. Different risk factors such as diabetes duration, blood pressure and lipid control have consistently been shown to correlate with both microvascular complications for diabetes. Despite the efforts of studies to correlate the two major diabetes mellitus microvascular complications, retinopathy and nephropathy, the relationship has not so far been clearly described. However, the currently literature data suggest that the presence of a pre-existing microvascular complication (retinopathy or nephropathy) may contribute to the development of another, especially in DM1 patients. More prospective studies are needed if we are to know the exact mechanism of how these diabetic microvascular diseases correlate, and if we are to develop a scoring system for predicting the development of those complications that will allow us to identify the patients at risk, with its consequent positive impact on patients' quality of life. The aim of the present study is to review the literature on the diagnosis, epidemiology, pathology, and risk factors in diabetic nephropathy and retinopathy, and then a revision of the possible relation between renal and retinal diabetic microangiopathy.

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Estudio de relación entre microalbuminuria y retinopatía diabética en la diabetes mellitus tipo 1

Cited by 3 publications

References 19 publications

Does HbA1c Level or Glomerular Filtration Rate Affect the Clinical Response to Endothelial Growth Factor Therapy (Ranibizumab or Aflibercept) in Diabetic Macular Edema? A Real-Life Experience

Does HbA1c Level or Glomerular Filtration Rate Affect the Clinical Response to Endothelial Growth Factor Therapy (Ranibizumab or Aflibercept) in Diabetic Macular Edema? A Real-Life Experience

Relationship between diabetic retinopathy, microalbuminuria and overt nephropathy, and twenty-year incidence follow-up of a sample of type 1 diabetic patients

Review of the Relationship between Renal and Retinal Microangiopathy in Diabetes Mellitus Patients

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