The association between chronic kidney disease and diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008-2010

• Published in: PloS one Vol. 10; no. 4; p. e0125338
• Main Authors: Park, Young-Hoon, Shin, Jeong Ah, Han, Jae-Hyung, Park, Yong-Moon, Yim, Hyeon Woo
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.04.2015; Public Library of Science (PLoS)
• Subjects: Adult; Adults; Aged; Aging; Chronic kidney failure; Confidence intervals; Cross-Sectional Studies; Data processing; Diabetes mellitus; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - epidemiology; Diabetic Retinopathy - pathology; Diabetics; Diet therapy; Edema; Epidermal growth factor receptors; Female; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Glucose - metabolism; Health surveys; Hemorrhage; Humans; Kidney diseases; Kidney transplantation; Lesions; Macular Edema - pathology; Male; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Metabolic Syndrome - pathology; Middle Aged; Nutrition; Nutrition Surveys - methods; Obesity; Ophthalmology; Pharmacology; Polls & surveys; Population Surveillance - methods; Proteinuria; Proteinuria - pathology; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - pathology; Republic of Korea - epidemiology; Retina; Retinopathy; Risk Factors; Surveys; Surveys and Questionnaires; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0125338

To explore the relationship between chronic kidney disease and diabetic retinopathy in a representative population of Korean diabetic adults. We analyzed data from the Korea National Health and Nutrition Examination Surveys (2008-2010). A total of 15,409 individuals (weighted frequency, 32,168,636) aged 19 and over who completed ophthalmologic and renal functional examinations were evaluated. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate of < 60 ml/min/1.73 m2 or proteinuria greater than 1+. Seven standard photographs from the Early Treatment for Diabetic Retinopathy Study were obtained from each eye after pharmacological pupil dilatation. Diabetic retinopathy (DR) was defined as the presence of 1 or more retinal microaneurysms or retinal blot hemorrhages with or without more severe lesions. Vision-threatening diabetic retinopathy (VTDR) was defined as the presence of a clinically significant macular edema (CSME) or proliferative diabetic retinopathy. CKD was significantly associated with DR and VTDR (odds ratio (OR), 95% confidence interval (CI); 2.49(1.43-4.35) and 3.74(1.56-8.95), respectively) in the diabetic population. After controlling for confounders, however, CKD was significantly associated only with DR [adjusted OR (aOR), 95% CI; 2.34(1.04-5.28)]. In the subgroup analysis for CKD, only proteinuria was significantly associated with DR and VTDR (aOR, 95% CI; 4.56(1.51-13.77) and 5.61(1.06-29.87), respectively) in this population. Our results show that CKD appears to be associated with DR and VTDR in a Korean diabetic population. In particular, proteinuria, not decreased eGFR, is more significantly associated with DR or VTDR.