Association of eGFR with stages of diabetic retinopathy and age-related macular degeneration in Indian population

Abstract

Purpose: To investigate the influence of glomerular filtration rate in renal disease decline and its association with diabetic retinopathy (DR) and age-related macular degeneration (ARMD) in patients in South India. Methods: A population-based cross-sectional study was conducted including participants with DR and ARMD recruited from urban and rural populations. The data collection included medical history, anthropometric measurements, and ophthalmic work-up. The estimated glomerular filtration rate (eGFR) was calculated using the equation of chronic kidney disease-epidemiology collaboration (CKD-EPI). The grading of AMD was done by a single experienced (more than 5 years) vitreoretinal surgeon as per the International ARM Epidemiological Study Group and it was staged based on grading in the worsened eye. Results: A decline in eGFR was observed as the severity of DR increased (P < 0.001). Baseline characteristics such as age (P < 0.001), duration of diabetes (P < 0.001), gender (P < 0.001), creatinine (P < 0.001), albumin to creatinine ratio (ACR; P < 0.001), albuminuria (P = 0.023), blood urea (P < 0.001), and high-density lipoprotein (HDL; P = 0.003) were found to be statistically significant. The risk for developing DR with CKD was found to be 5 times higher in male patients compared to female patients. Age and high blood urea level, diastolic blood pressure, mild and moderate DR were the risk factors associated with CKD. A decline in eGFR was observed as the severity of ARMD increased (P < 0.001). The risk factors associated with CKD were age, gender, smoking, alcohol consumed, presence of hypertension, duration of diabetes, systolic and diastolic blood pressure, history of diabetes, body mass index (BMI), serum triglycerides, and serum HDL cholesterol. Conclusion: Reduced eGFR values were associated with an increase in the severity of DR and ARMD.