The relationship between diabetic retinopathy and diabetic nephropathy in a population-based study in Korea (KNHANES V-2, 3).

Abstract

PURPOSE: To determine the risk factors for and relationship between diabetic

retinopathy (DR) and diabetic nephropathy (DN), including microalbuminuria and

overt nephropathy, in a population-based study of diabetes mellitus (DM) patients

in Korea. METHODS: This was a population-based, cross-sectional study. From the

fifth (2011, 2012) Korea National Health and Nutrition Examination Survey

(KNHANES), 971 participants with type 2 DM were included. The prevalence of DR

and DN was determined. Multivariate logistic regression was performed to

determine risk factors, including DR, associated with DN in the Korean

population. RESULTS: In DM patients, we observed a prevalence of 20.0% for any DR

and 3.8% for proliferative diabetic retinopathy (PDR). Microalbuminuria

prevalence was 19.3% and overt nephropathy prevalence was 5.5%. The risk factors

of microalbuminuria were presence of hypertension; higher systolic blood

pressure, serum hemoglobin A1c (HbA1c), and serum blood urea nitrogen level; as

well as the presence of PDR. The risk factors of overt nephropathy were long

duration of DM; high levels of HbA1c, systolic blood pressure, total cholesterol,

and serum creatinine; as well as the presence of DR CONCLUSIONS: Proliferative

diabetic retinopathy is associated with microalbuminuria and DR is associated

with overt nephropathy in Korean DM patients. Our findings suggest that when an

ophthalmologist finds the presence of DR or PDR, timely evaluation of the

patient's renal status should be recommended.