Type 2 diabetic patients with diabetic retinopathy and concomitant microalbuminuria showed typical diabetic glomerulosclerosis and progressive renal dysfunction

Moriya, Takuya; Matsubara, Madoka; Kishihara, Eriko; Yoshida, Yuki; Ouchi, Motoshi

doi:10.1016/j.jdiacomp.2016.04.007

Cited by 16 publications

(10 citation statements)

References 24 publications

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“…However, other recent study by McKay et al showed that mere retinal microvascular parameters including vascular caliber, tortuosity, and fractal dimension cannot predict renal outcome in type 2 DM patients [26]. Moriya et al suggested that microalbuminuria together with DR result in glomerulosclerosis and renal progression [27]. However, our study suggested that DR severity independently affect renal function deterioration after adjustment for albuminuria status.…”

Section: Discussioncontrasting

confidence: 68%

Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus

et al. 2019

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Since both retinopathy and nephropathy are major diabetic microvascular complications, we investigated whether severity of diabetic retinopathy (DR) has adverse effects on renal function and albuminuria in the patients with type 2 diabetes mellitus (DM). We screened 2,197 adult patients with type 2 DM who had undergone fundus exam between August 2006 and February 2014. Among them, 1,592 subjects with available serial renal function and albuminuria measurement were included in the analysis. DR status was classified as no DR, non-proliferative DR (NPDR), and proliferative DR (PDR). The risk of CKD progression was assessed according to DR severity. A total of 384 (24.1%) had NPDR and 202 (12.7%) had PDR at either eye. The mean follow-up period was 5.6±2.1 years. DR was associated with lower body mass index, lower plasma hemoglobin, lower serum albumin level, longer duration of DM, poorer control of blood sugar, lower estimated glomerular filtration rate (eGFR), and greater amount of albuminuria. Interestingly, baseline DR severity was associated with faster renal function decline and greater albuminuria progression. In multivariate analysis, NPDR had 2.9 times and PDR had 16.6 times higher risk for CKD progression. Our findings showed that baseline DR severity is a prognostic factor for future CKD progression in type 2 DM patients. Therefore, clinicians must evaluate DR severity at the first visit and closely monitor renal function and albuminuria in the subjects with severe DR.

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Section: Discussioncontrasting

confidence: 68%

Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus

et al. 2019

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“…The presence of microalbuminuria in DR patients is a common condition. In other words, DR patients usually suffer from renal failure (10,12).…”

Section: Discussionmentioning

confidence: 99%

“…The level of damage to the glomerulus identifies the type of albuminuria; the high permeability for albumin in the glomerulus and more ACR are the hallmarks of more damage (9). Microalbuminuria is more prevalent in DR patients, compared to macroalbuminuria (10).…”

Section: Introductionmentioning

confidence: 99%

Association of Microalbuminuria and Bevacizumab Therapy Outcomes in Diabetic Retinopathy Patients

Rasoulinejad

2021

Nephro-Urol Mon

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Background: Diabetic retinopathy (DR) is a visual impairment-related eye disease developed by long-term hyperglycemic status. Diabetic condition in DR patients leads to diabetic organopathies (e.g., renal failure). Albuminuria, as a hallmark of renal failure, can be correlated with visual indicators in DR patients. Objectives: This study aimed to investigate the role of albuminuria status in visual acuity (VA) and bevacizumab therapy outcomes in DR patients. Methods: In this retrospective study, 48 DR patients were admitted to the Ophthalmology Center of Ayatollah Rouhani Hospital, affiliated with Babol University of Medical Sciences, Babol, Iran. The retinopathy status and VA were identified before and after treatment through 45 days of bevacizumab therapy. In addition, fast blood sugar, hemoglobin A1c, urine albumin, and urine creatinine were evaluated using standard laboratory methods. Results: The VA value before treatment in microalbuminuric DR patients (0.106 ± 0.036) was significantly lower than non-microalbuminuric DR patients (0.347 ± 0.286; P < 0.001). Furthermore, VA value after treatment in microalbuminuric DR patients (0.115 ± 0.071) was significantly lower than non-microalbuminuric DR patients (0.355 ± 0.272; P < 0.001). There was no significant difference in the percentage of VA increase between microalbuminuric and non-microalbuminuric patients. Moreover, the albumin-to-creatinine ratio (ACR) was correlated with a lower VA level before and after treatment (P < 0.001 for both). There was no correlation between the percentage of VA increase with ACR, albumin, and creatinine. Conclusions: The current study results showed that different VA before and after bevacizumab therapy status was correlated with microalbuminuria status. Additionally, microalbuminuria status did not affect the percentage of VA increase in the treatment of DR patients.

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“…In the present study, renal dysfunction was examined in GDM mice at E18.5 by determining the levels of urine albumin and serum β2-microglobulin, and H&E and PAS staining were performed to investigate the morphology of kidney tissues. Urine albumin, a marker of impaired glomerular filtration rate, is considered a marker of early DN (30). The American Diabetes Association has recommended annual testing for the levels of urine albumin in patients with T2DM to identify chronic renal disease (31).…”

Section: Discussionmentioning

confidence: 99%

Renal dysfunction in a mouse model of GDM is prevented by metformin through MAPKs

Liu

Tong

et al. 2019

Mol Med Report

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Gestational diabetes mellitus (GDM) incidence is increasing worldwide. In the present study, the effects of metformin on high fat diet (HFD)-induced renal dysfunction were investigated in GDM mice. In addition, the molecular mechanisms underlying metformin function were examined. GDM was induced by feeding pregnant mice a HFD, and mice were treated with two different doses of metformin (300 and 600 mg/kg/day) or PBS between embryonic day 11.5 (E11.5) and E17.5. The pregnant mice at E18.5 were utilized to analyze the effects of metformin on renal dysfunction. Renal function and the protein expression levels of inflammatory cytokines and factors of the mitogen-activated protein kinase (MAPK) signaling pathway in the kidneys of pregnant mice were assessed by ELISA and western blotting. Data obtained during late pregnancy suggested that metformin significantly decreased body weight and the levels of blood glucose in GDM mice, as assessed by the glucose tolerance test and the homeostatic model assessment for insulin resistance. The levels of microalbumin and serum β2-microglobulin in GDM mice during late pregnancy were decreased following treatment with metformin. Furthermore, serum levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α, and phosphorylation of MAPK1/3, MAPK14 and MAPK8 in the kidneys were decreased in GDM mice following metformin treatment at E18.5, compared with the untreated GDM group. The present study suggested that inflammation may be associated with renal dysfunction in GDM mice, and that the MAPK signaling pathway may be involved in the protective effect of metformin on renal dysfunction in GDM mice.

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Type 2 diabetic patients with diabetic retinopathy and concomitant microalbuminuria showed typical diabetic glomerulosclerosis and progressive renal dysfunction

Cited by 16 publications

References 24 publications

Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus

Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus

Association of Microalbuminuria and Bevacizumab Therapy Outcomes in Diabetic Retinopathy Patients

Renal dysfunction in a mouse model of GDM is prevented by metformin through MAPKs

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