The comparative evaluation of retinal findings in patient with diabetic and non diabetic renal failure

Abstract

Background: Diabetic nephropathy (DN) caused by diabetes mellitus is one of the major causes of end-stage renal failure worldwide. Clinically, microalbuminuria is an important index to assess the progression of DN. Diabetic retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are reported to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources. Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Objective: To assessing the retinal findings in patient with diabetic renal failure and in nondiabetic renal failure Methods: In each of two groups, 20 participants referring to Central Hospitals, Mongolia between November 2018 and May 2019 were included in this study. Data were collected using a questionnaire after an interview and ocular examination. Demographic variables, diabetic retinopathy, ocular examination datas, and renal functional findings such as serum creatinine, eGFR were analyzed. The International Council of Ophthalmology grading system was used for assessing the retinopathy. Results: For case(diabetic) group, n=20 participants (mean age 56.80±11.4 years ) for control group, n=20 participants (mean age 47.95±8.08years ) were enrolled in this study, the mean age is significantly lower in control group (P value - 0.001). BCVA was 0.53±0.35 in case group, wherein 0.95±0.19 in control group. There are significant difference between in 2 groups. (P value - 0.001). Our findings show that, 17(92.5%) patients with diabetic renal failure had DR and no one has DR among non-diabetic patients. Conclusion: Our study demonstrates a strong association between retinopathy and diabetic nephropathy, highlighting the need for renal evaluations in patients with DR and consistent with the hypothesis that retinovascular pathology may reflect renal vascular pathology.