Study of Clinical Correlation between Diabetic Retinopathy and Diabetic Nephropathy - A Cross-Sectional Observational Study in Eastern India

2021 ◽  
Vol 8 (30) ◽  
pp. 2685-2690
Author(s):  
Bivas Bala ◽  
Viswanath Pratap ◽  
Soumi Kanji
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Glycosylated Haemoglobin ◽  
Ophthalmological Examination ◽  
Keywords Diabetic Retinopathy ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Stage Renal Disease

BACKGROUND In diabetes mellitus microvascular damages at various end-organ frequently occurs and leads to development of diabetic nephropathy as well as diabetic retinopathy. Diabetic nephropathy ultimately causes end stage renal disease. Diabetic retinopathy even at its earlier stage is easily suspected by simple clinical examination in any ophthalmological clinic. We wanted to study the relationship between various stages of diabetic retinopathy with diabetic nephropathy. METHODS 1209 diagnosed patients of diabetic mellitus were screened for presence of diabetic retinopathy. First comprehensive ophthalmological examination including slit-lamp bimicroscopy and indirect ophthalmoscopy were done and then clinically typing of diabetic retinopathy according to ETDRS classification was done. Then all diagnosed case of diabetic retinopathy further examined for blood Glycosylated haemoglobin, blood urea and serum creatinine to detect diabetic nephropathy. RESULTS 273 patients were included in this study. Average age of patients was 64.6 years with mean duration of diabetes mellitus was 7.4 years. Patients suffering from severe NPDR and PDR had association with poor control of blood glycosylated haemoglobin. Patients with mild NPDR 31.1 %, Moderate NPDR 52.3 %, severe NPDR 67.4 % and in PDR 65.2 % patient had blood urea more than 40 mg / dl. In mild NPDR group 32.2 %, moderate NPDR 55.4 %, severe NPDR 67.4 % and in PDR group 63.9 % patients had serum creatinine more than 1.5 mg / dl. We have found statistically significant correlation between HbA1c level and severity of diabetic retinopathy. Prevalence of nephropathy increased with increments in the grade of retinopathy. CONCLUSIONS A significant number of patients with severe NPDR or PDR had increased blood urea and serum creatinine level. Clinical grading of diabetic retinopathy gives us a clue about the presence of diabetic nephropathy. As diagnosis of diabetic retinopathy is simple and straight forward clinical procedure and it can be done all ophthalmological se up, we recommend all patient with diabetic retinopathy must be screened for nephropathy. KEYWORDS Diabetic Retinopathy, Diabetic Nephropathy, Glycosylated Haemoglobin, Blood Urea, Serum Creatinine

scholarly journals Etiology of End-Stage Renal Disease and Arterial Stiffness among Hemodialysis Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Balsam El Ghoul ◽  
Yazan Daaboul ◽  
Serge Korjian ◽  
Andrew El Alam ◽  
Anthony Mansour ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Arterial Stiffness ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

Background. Prior studies have demonstrated that conventional and emerging CV risk factors are associated with worsening arterial stiffness among end-stage renal disease (ESRD) patients on hemodialysis. The present cross-sectional study evaluates the association between the etiology of ESRD and arterial stiffness among a cohort of hemodialysis patients.Methods. Etiology of ESRD was identified from patients’ medical records and classified as either vascular renal disease, diabetic nephropathy, nondiabetic glomerulopathy, tubular interstitial nephropathy, hereditary nephropathy, or ESRD of unconfirmed etiology.Results. A total of 82 subjects were enrolled. cfPWV was independently associated with the composite of either diabetic nephropathy or vascular renal disease (p=0.022), pulse pressure (p=0.001), and a history of CV events (p=0.025), but not history of hypertension or diabetes mellitus alone. The median cfPWVs in diabetic nephropathy and vascular renal disease were comparable and significantly higher than median cfPWVs in other etiologies of ESRD.Conclusion. The study suggests that the etiology of ESRD is independently associated with arterial stiffness among hemodialysis patients. Furthermore, arterial stiffness was higher among patients who developed renal sequelae of either diabetes mellitus or hypertension as compared with those who have a history of either diabetes mellitus or hypertension alone.

scholarly journals MICROVASCULAR AND MACROVASCULAR DISEASES IN DIABETIC NEPHROPATHY

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr.Nitin Chauhan ◽  
Dr. Fateh Singh Sinsinwar
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Diabetic Nephropathy ◽  
Coronary Artery ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
The Mean ◽  
Artery Disease ◽  
Stage Renal Disease ◽  
End Stage

Introduction:  Diabetes mellitus (DM) can be described as a metabolic disorder which is characterized by hyperglycemia which develops as a consequence of defects in insulin secretion or its action, or both. Diabetes is strongly associated with microvascular and macrovascular diseases and its complications, which includes nephropathy, retinopathy, microvascular neuropathy and ischemic heart disease, peripheral vascular disease, and macrovascular cerebrovascular disease which results in organ and tissue damage in about one third to one half of people with diabetes. The early manifestation of DN is microalbuminuria, which eventually progresses to overt albuminuria that is increased albumin levels in the urine, which indicates more severe renal dysfunction, and ultimately leading to renal failure. Material and Methods: Patients were screened and clinically diagnosed accor­ding to World Health Organization (WHO) criteria. Demographic characteristics of the patients were taken, height and weight were recorded, and body mass index (BMI) was calculated in metrics units. Blood investigations were carried out like blood glucose, HbA1C, cholesterol, Triglycerides (TG), serum creatinine, creatinine clearance, and24-hour uri­nary protein were investigated for each patient. Glomerular filtration rate (GFR) was calcu­lated. Rate of change of GFR was calculated. Duration of follow-up, age at onset of diabetes, duration of complications, and time for doubling of serum creatinine were recorded and calculated. Results: A total of 50 patients were included in the study who were diagnosed as DN by the physician. Mean age of the patients with DN was observed as 64.24 ± 13.68. There were 31 (62%) male and 19 (38%) and female. Mean duration of nephro­pathy was 7.2 ± 2.9 years. Family history of DN was shown in 5 (10%). Diabetic complications were recorded and tabulated. Retinopathy was observed in 23 (46%) of the cases, Coronary artery disease in 28 (56%), Angina in 22 (44%), stroke in 6(12%), Diabetic foot in 4 (8%), Hypertension in 43 (86%), blindness in 3 (6%) and end stage renal disease was observed in 12 (24%) of the cases. There were 2 (4%) deaths. The mean time to onset of diabetic com­plications from the diagnosis of diabetes in present study was 9.6 ± 2.9 (Mean± SD) years for coronary artery disease, 15.3 ± 7.3 years, for retinopathy, 11.3 ± 3.4 years for neuropathy, and 6.3 ± 2.9 years for diabetic foot. Patients those who were diagnosed >20 years, end stage renal disease was observed in them. The mean proteinuria was 2.34 ± 1.88 gm/L. Protein excretion < 0.5 was found in 15 (30%) patients, mean HbA1C was 9.7 ± 1.5(Mean± SD). Conclusion: Age, male gender, duration of diabetes, baseline HbA1C, blood pressure, and renal function are risk factors for diabetic complications and nephropathy. Keywords: microvascular, diabetes mellitus, diabetic nephropathy

scholarly journals Correlation of microalbuminuria with glycosylated haemoglobin in patients of diabetes having nephropathy

2017 ◽  
Vol 4 (3) ◽  
pp. 805 ◽  
Author(s):  
Mayank Gupta ◽  
Jagat Pal Singh
Keyword(s):  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Blood Sugar ◽  
Glycated Haemoglobin ◽  
Glycosylated Haemoglobin ◽  
Duration Of Diabetes ◽  
Presenting Symptoms ◽  
Increase With Increase ◽  
Detailed Medical History ◽  
Stage Renal Disease

Background: Diabetes mellitus is the leading cause of end stage renal disease (ESRD) and is responsible for 30-40% of all ESRD. Objectives of the study were to assess the renal functional status in diabetic nephropathy patients by evaluating and correlating glycosylated haemoglobin levels in diabetic with microalbuminuria.Methods: Present observational study was done including 75 patients having diabetic nephropathy, who attended JAH and attached groups of hospitals from May 2014 to November 2015. Detailed medical history including duration of diabetes and relevant clinical examination including glycated haemoglobin, blood urea, serum creatinine, and urinary microalbumin were recorded for each patient. All the analysis was performed using IBM SPSS Ver. 20. Significance is assessed at 5% level of significance.Results: Mean age of study population was 52.4±15.2 years with male preponderance (58.67%). Increased micturation frequency (48%) was the most common presenting symptoms. Mean fasting blood sugar (FBS), post prandial blood sugar (PPBS), HbA1c, duration of diabetes, blood pressure, microalbuminuria and serum creatinine was 151.5±48.5 mg/dL and 240.3±59.7 mg/dL, 9.03±2.1%, 9.37±5.96 years, 132±22.4/84±12.5 mmHg, 118.6±86.7 mg/day and 1.33±0.64 mg/dl respectively. Microalbuminuria (r=0.91, p≤0.05), HbA1c (r=0.67, p≤0.05) and serum Creatinine (r=0.33, p≤0.05) were positively correlated with duration of diabetes.Conclusions: Level of microalbuminuria increase with increase in duration of diabetes and worsening of diabetes.

scholarly journals Study of Correlation between Renal Function Test and Severity of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (20) ◽  
pp. 1511-1514
Author(s):  
Archana Ramkrishna Thool ◽  
Nikunj Kishore Dhande ◽  
Sachin Vishwanath Daigavane
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Diabetic Retinopathy ◽  
Serum Creatinine ◽  
Blood Urea Nitrogen ◽  
Glycosylated Haemoglobin ◽  
Function Test

BACKGROUND Retinopathy and nephropathy are chronic vascular complications of type 2 diabetes mellitus, this eventually leads to end stage renal disease and blindness. Diabetic retinopathy is an important cause of legal blindness in 20 - 70 years. The purpose of the study was to establish association between severity of diabetic retinopathy with systemic levels of glycosylated haemoglobin and renal function test. METHODS This is a cross sectional study conducted among 75 patients with type 2 diabetes mellitus attending the ophthalmology out-patient department (OPD) of Acharya Vinoba Bhave Hospital, Wardha and patients referred from the hospital. Detailed fundus examination and staging of diabetic retinopathy (DR) was done. Glycosylated haemoglobin levels, serum creatinine and blood urea nitrogen were measured. RESULTS Majority of patients were in the age range of 61 to 70 years. Mean ± SD of 3 parameters in patients with no DR, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR) were as follows: Serum creatinine 1.12 ± 0.41, 1.21 ± 0.53, 1.35 ± 0.49, 1.55 ± 0.22 and 1.70 ± 0.23 respectively. P = 0.007. Blood urea nitrogen (BUN) 28.62 ± 4.20, 31.83 ± 7.20, 37.31 ± 12.57, 44.21 ± 7.53 and 48.76 ± 5.08 respectively. P = 0.0001. HbA1c l, 6.72 ± 0.60, 8.14 ± 0.98, 8.52 ± 2.67, 9.96 ± 1.22 and 12.14 ± 1.96 respectively. P = 0.0001. All the 3 parameters were statistically significant. 40 % of cases had clinically significant macular oedema. CONCLUSIONS Poor glycaemic control as seen by higher levels of glycosylated haemoglobin and deranged renal function is associated with severe form of DR. KEY WORDS Diabetes Mellitus, Diabetic Retinopathy, Serum Creatinine HbA1c and BUN

scholarly journals Histopathological Pattern of Glomerulonephritis: Experience from BIRDEM General Hospital, Dhaka, Bangladesh

2017 ◽  
Vol 6 (2) ◽  
pp. 67-73
Author(s):  
Tabassum Samad ◽  
Sarwar Iqbal ◽  
Wasim Md Mohosinul Haque ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
General Hospital ◽  
End Stage Renal Disease ◽  
Cross Sectional ◽  
Cortical Necrosis ◽  
Number Of Patients ◽  
Common Causes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Nephrotic Range Proteinuria

Background: Glomerulonephritis (GN) remains the most probable underlying cause of end stage renal disease of uncertain aetiology in many developing countries including Bangladesh. The pattern of glomerular disease varies widely from country to country. In Bangladesh, the incidence and histological pattern of GN is inadequately described. We performed a study, aiming to determine the pattern of GN in a diabetic hospital of our country.Methods: It was a cross-sectional hospital based prospective study conducted at BIRDEM General Hospital starting from July 2013 to December 2014. It included all patients with suspected GN who underwent native kidney biopsy.Results: Total 57 biopsies were performed and four cases other than primary or secondary GN (renal cortical necrosis 1, tubulointertsitial nephritis 2,chronic GN 1) were excluded i.e total number of PGN was 37 and secondary GN was 16. number of patients with were 53. M:F was 1.2:1.Mean age was 42.35±15(14-72) years. Thirty one (58.49%) of the study subjects had diabetes mellitus (DM). Mesangialproliferative GN (15/37,40.5%) and diabetic nephropathy (9/16,56%) were the commonest histopathological pattern found among primary and secondary GN respectively. Membranoproliferative GN (10/37,27%),was the second commonly observed pattern followed by focal segmental proliferative GN (8%), membranous nephropathy (8%), focal segmental glomerulosclerosis (5.4%) in primary GN and lupus nephritis (6/16,38%) and Wegeners granulomatosis (1/16) were other varieties in secondary group. Among 53 cases, 37 had proliferative variety. Nephrotic range proteinuria (41.5%) was the commonest indication of biopsy and 22% had post biopsy bleeding and 3.7% required blood transfusion.Conclusion: In conclusion, mesangial proliferative and membranoproliferative GN are the two common causes of primary GN. Diabetic nephropathy is the commonest cause of secondary GN. Nephrotic range proteinuria was the main indication of biopsy. Post biopsy complication was negligible. Creation of a national renal registry is essential for obtaining more specific epidemiological data.Birdem Med J 2016; 6(2): 67-73

scholarly journals DIABETIC RETINOPATHY IN PATIENTS OF TYPE2 DIABETES MELLITUS WITH DIABETIC NEPHROPATHY

2020 ◽  
pp. 1-2
Author(s):  
Somedeb Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Macular Edema ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Female Ratio ◽  
Clinically Significant

To evaluate severity of diabetic retinopathy in patients of type 2 diabetes mellitus with diabetic nephropathy. This was a cross sectional study of 159 eyes of 80 patients aged above 40 years, diagnosed to have Type 2 DM with diabetic nephropathy. All the patients were investigated for albuminuria. The retinopathy was evaluated according to the Early Treatment Diabetes Retinopathy Study (ETDRS) classification into nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Diabetic macular edema was characterized as clinically significant macular edema (CSME) and non-CSME. The severity of retinopathy was correlated with nephropathy. In this study, mean age of the patients were 58.26± 6.43 years and male to female ratio 1.96:1. Out of 80 diabetic patients, 22(27.5%) patients had microalbuminuria and 58 (72.5 %) had macroalbuminuria. In this study, 67 (83.7%) patients had diabetic retinopathy, out of which 14 (20.9%) patients had mild NPDR, 20 (29.9%) had moderate NPDR, 16 (23.9%) had severe NPDR, 5(7.4%) had very severe NPDR and 12 (17.9%) had PDR. In 22 patients with microalbuminuria 6 (27.3%) had mild NPDR, 4 (5.0%) had moderate NPDR and none had maculopathy. In 58 patients with macroalbuminuria, 8 (13.8%) had mild NPDR, 16 (27.6%) had moderate NPDR, 16 (27.6%) severe NPDR, 5 (8.6%) has very severe NPDR, 4(6.9%) had early PDR and 8(13.8%) had high-risk PDR, 14 (24.1%) had CSME and 4 (6.9%) had non-CSME. In our study, diabetic nephropathy patients with macroalbuminuria had more severe type of DR than patients with microalbuminuria.

A study on evaluating blood urea and serum creatinine in diabetes mellitus patients

2022 ◽  
Vol 8 (4) ◽  
pp. 285-288
Author(s):  
S L V Sankeerthi C H ◽  
Sai Ravi Kiran Biri ◽  
Sandhya Rani T ◽  
Rajkumar Gundu ◽  
Aravind Vadlakonda
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
End Stage Renal Disease ◽  
Filtration Rate ◽  
Diabetic Patients ◽  
Age Limit ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Ideal

Diabetes is one of the leading causes for end stage renal disease and nephropathy. Increases of blood urea and serum creatinine are due to abnormal renal function and also reduction in glomerular filtration rate. So, Urea and Creatinine are the ideal biomarkers to correlate the progression of diabetic nephropathy. Aim of the study is to evaluate the blood urea & serum creatinine with HbA1C in Diabetes mellitus patients.: A total of 50 cases and 30 controls were selected in our study. Blood samples were collected for blood urea, serum creatinine, HbA1C, Fasting plasma glucose and Post prandial blood sugar with age limit of 35-65 years. Mean ±SD was calculated for all these parameters. Blood urea and Serum creatinine are statistically significant in Diabetic patients when compared to the controls.Our study shows that blood urea and serum creatinine can be used as biomarkers in the early detection of diabetic nephropathy. These parameters help in reducing the severity of renal failure.

scholarly journals Renal cortex echogenicity increases degree of retinopathy in diabetes mellitus

2016 ◽  
Vol 35 (1) ◽  
pp. 19
Author(s):  
Indah Maulidawati ◽  
Abdurrahim Rasyid Lubis ◽  
Dharma Lindarto
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Renal Cortex ◽  
Cross Sectional Study ◽  
Spearman Correlation ◽  
Renal Ultrasonography ◽  
Cross Sectional ◽  
Correlation Test ◽  
Spearman Correlation Test

Background<br />The number of people with diabetes mellitus (DM) is increasing due to population growth, aging, and increasing prevalence of obesity. Diabetic retinopathy and diabetic nephropathy are two main complications of DM. Some studies suggest a correlation between diabetic nephropathy and diabetic retinopathy. However, other studies found that renal cortex echogenicity is associated with chronicity of kidney disease and renal histopathology. The aim of this study was to determine whether there is a correlation between renal cortex echogenicity as determined by renal ultrasonography and degree of retinopathy as determined by funduscopy in subjects with DM.<br /><br />Methods<br />A cross sectional study was conducted on 41 DM subjects from September to November 2014. Data obtained by anamnesis, physical examination, and examination of ureum, creatinine, urinalysis, glycated hemoglobin (HbA1c), renal and urinary tract ultrasonography and funduscopy, were collected from all subjects. Blood samples were taken from the median cubital vein for biochemical measurements using COBAS automated analyzers. Normality of data distribution was tested using the Shapiro-Wilk test. To determine the relationship between variables the Spearman correlation test was used. <br /><br />Results<br />Using the Spearman correlation test, a strongly significant correlation was found between degree of renal cortex echogenicity and degree of retinopathy (r=0.773; p=0.0001). A significant relationship was also found for the degree of retinopathy with age (r=0.317; p=0.044), duration of diabetes mellitus (r=0.639; p=0.0001) and HbA1c (r=0.681; p=0.001).<br /><br />Conclusion<br />This study found that renal cortex echogenicity increased the degree of diabetic retinopathy in diabetic subjects. Renal ultrasonography for patients with type 2 DM has a great role in diagnosing and grading diabetic retinopathy.

scholarly journals PGNMID in a patient with diabetes mellitus

2021 ◽  
pp. 239936932098478
Author(s):  
Joana Marques ◽  
Patrícia Cotovio ◽  
Mário Góis ◽  
Helena Sousa ◽  
Fernando Nolasco
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Renal Disease ◽  
Renal Involvement ◽  
Organ Damage ◽  
Therapeutic Implications ◽  
Stage Renal Disease

Diabetic nephropathy is a well known complication of diabetes mellitus and the leader cause of end -stage renal disease worldwide. Nonetheless, other forms of renal involvement can occur in diabetic population. Since it has prognostic and therapeutic implications, differentiating non-diabetic renal disease from diabetic nephropathy is of great importance. We report an 80-year-old man with well-controlled type 2 diabetes mellitus and hypertension, who presented with rapid deterioration of renal function, nephrotic proteinuria, microscopic hematuria and leukocyturia. The atypical clinical presentation prompted us to perform a kidney biopsy. A diagnosis of proliferative glomerulonephritis with monoclonal immunoglobulin deposits (light chain only variant) was made, with however some chronic histological aspects which made us took a conservative therapeutic attitude. We emphasize that other causes of chronic proteinuric kidney disease should be considered in patients with type 2 diabetes mellitus, based on clinical suspicion, absence of other organ damage and mostly if an atypical presentation is seen. We review the spectrum of monoclonal gammopathies of renal significance, focusing on this rare and newly describe entity.

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