More than a third of patients with diabetes and chronic kidney disease also develop diabetic retinopathy (DR), according to a study published in the American Journal of Ophthalmology. The authors looked at data extracted from the National Health and Nutrition Examination Surveys database. The data involved the records of patients who were 40 years old or older. The investigators found DR in 27.8% of the patients reviewed in total. However, of those patients, 36.2% had kidney disease and only 23.4% did not. Furthermore, in the patients who had both kidney disease and DR, 8.2% had a vision-threatening level of DR. In patients without kidney disease, on 2% had a vision-threatening level of DR.

Most worrying, however, is the finding that, compared with participants with neither DR nor kidney disease, those with both had 3.6-fold increased risk for all-cause mortality. Luckily, the researchers say that many of the risk factors associated with DR are modifiable. The team defined diabetes as hemoglobin A1c ≥6.5% or self-report and chronic kidney disease by urinary albumin/creatinine ≥30mg/g or glomerular filtration rate <60ml/min/1.73m2.

Pavkov M, Harding J, Chou C, Saadine J. Prevalence of Diabetic Retinopathy and Associated Mortality Among Diabetic Adults With and Without Chronic Kidney Disease. Am J Ophthalmol. November 12, 2018.  [Epub ahead of print].