Albuminuria in diabetic patients increases risk of diabetic retinopathy

In individuals with diabetic macular edema (DME), albuminuria is linked with a greater degree of diabetic retinopathy (DR) and a poor response to antiangiogenic treatment, says an article published in International Ophthalmology Journal.

Diabetes mellitus (DM) is among the world's most common chronic illnesses, and its incidence is expected to rise. DR and DME are two of the most common microvascular problems in diabetic patients, with DME causing vision loss in people of working age and having a significant financial impact. Ane Gibelalde and colleagues undertook this study to investigate the probable link between renal function and the severity of DR, as well as the degree of response to DME therapy, because studies provide conflicting data about the association of albuminuria with diabetic eye disease.

A total of 367 individuals were recruited and divided into three groups: simple diabetic retinopathy (n = 97), proliferative diabetic retinopathy (n = 94), and DME (n = 175). Similarly, patients with DME were separated into two groups: those who responded to antiangiogenic medications (n = 96) and those who did not (n = 79). The researchers looked at age, diabetes type, arterial hypertension (AHT), creatinine, HbA1c, albuminuria, and glomerular filtration rate. The chi-square test and the t student were employed in the statistical analysis to compare each group. A binary logistic regression model was used to estimate the odds ratio and confidence intervals for the connection between albuminuria and responsiveness to therapy in the DME group.

The key findings of this study were:

1. In regards to the presence or absence of albuminuria, the three major groupings differ.

2. Albuminuria is more common in individuals who have more severe DR (PDR and DME) than in persons with simple DR.

3. A positive link was discovered in the logistic regression analysis model, and the odds ratio for the albuminuria parameter is 2.78.

In conclusion, controlling factors that increase urine albumin excretion, such as AHT and smoking, may enhance the therapeutic response of individuals who do not react to antiangiogenic medicines. And so, interdisciplinary teams are required to optimize treatment outcomes.

Reference:

Gibelalde, A., Amenabar Alonso, A., Pinar-Sueiro, S., Bilbao-Garay, I., Juaristi Eizmendi, L., & Sampedro, A. (2022). Albuminuria as a biomarker of severity in diabetic retinopathy and in the response to intravitreal treatment in diabetic macular edema. In International Ophthalmology. Springer Science and Business Media LLC. https://doi.org/10.1007/s10792-022-02604-y