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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2009, Number 4

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Rev Mex Oftalmol 2009; 83 (4)

Frecuencia de nefropatía diabética en pacientes con retinopatía diabética y edema macular

Razo-Blanco HDM, Lima-Gómez V, Espinosa-Laganá R, Pérez-Soriano SD, Treviño-Becerra A

Language: Spanish
References: 28
Page: 226-230
PDF size: 95.16 Kb.


ABSTRACT

Background: The association between diabetic retinopathy (DR) and the manifestations of diabetic nephropathy (DN) like microalbuminuria and chronic renal failure has been described. The vascular permeability which plays an important role in the Clinical Significant Macular Edema (CSME) could also affect the kidney. The purpose of the study is to identify the presence of DN in patients with diabetic CSME, which could help with an early detection of DN.
Methods: An Observational, prospective, cross-sectional, analytical, open study was conduced. Diabetic patients with CSME who were attended in general hospital (July 2007 –December 2008), age 40 to 80 years, with biochemical evaluation were included. The proportion and confidence intervals at 95% (95%C.I.) of every grade of DN (Mogensen classification) were calculated.
Results: Fifty three eyes of 38 patients, average age 61.68 years old, 60.5% females. 49.1% had monofocal CSME, and 13.2% had proliferative DR. Three patients did not present DN (8.3%, 95%C.I. 0-17.07), 1 presented degree I (2.8%, 95%C.I. 0-8.05), 10 degree III (26.3%, 95%C.I. 12.30-40.3), 8 degree IV (21.1%, 95%C.I. 8.13-34.07) and 16 degree V (42.1%, 95%C.I. 26.4-57.8).
Conclusions: Up to 100% of the diabetics with CSME could present functional disturbance corresponding to DN. The proportion of the most severe degree could exceed 50%. The evaluation of the kidney function by the nephrologists is necessary in the diabetic patients with CSME.


REFERENCES

  1. Matsuyama K, Ogata N, Matsuoka M y cols. Relationship between pigment epithelium-derived factor (PEDF) and renal function in patients with diabetic retinopathy. Mol Vis 2008; 14:992-996.

  2. Romero P, Baget M, Mendez I y cols. Diabetic macular edema and its relationship to renal microangiopathy: a sample of Type I diabetes mellitus patients in a 15-year follow-up study. J Diabetes Complications 2007; 21:172-180.

  3. Trevisan R, Vedovato M, Mazzon C y cols. Concomitance of diabetic retinopathy and proteinuria accelerates the rate of decline of kidney function in type 2 diabetic patients. Diabetes Care 2002; 25:2026-2031.

  4. Gross JL, de Azevedo MJ, Silveiro SP y cols. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care 2005; 28:164-176.

  5. Fong DS, Aiello L, Gardner TW y cols. Retinopathy in diabetes. Diabetes Care 2004; 27(Suppl 1):S84-87.

  6. Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care 2003; 26:2653-2664.

  7. Ryan S, Hinton D, Schachat A, Wilkinson C. Retina, 4th ed. St. Louis, Mosby-Yearbook, 2008.

  8. Varma R, Paz SH, Azen SP y cols. The Los Angeles Latino Eye Study: design, methods, and baseline data. Ophthalmology 2004; 111:1121-1131

  9. Asociación Mexicana de Retina, Sociedad Mexicana de Oftalmología, Asociación Panamericana de Oftalmología. Resultados del Día Panamericano de detección de retinopatía diabética (3 de julio de 1999, día D). Rev Mex Oftalmol 2005; 79:88-92.

  10. Lima-Gómez V. Comparación del grosor macular con y sin edema en pacientes diabéticos mexicanos. Rev Mex Oftalmol 2007; 81:214-218.

  11. Hu G, Jousilahti P, Tuomilehto J. Joint effects of history of hypertension at baseline and type 2 diabetes at baseline and during follow-up on the risk of coronary heart disease. Eur Heart J 2007; 28:3059-3066.

  12. Burlando G, Sanchez RA, Ramos FH y cols. Latin American consensus on diabetes mellitus and hypertension. J Hypertens 2004; 22:2229-2241.

  13. UKPDS 38. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: BMJ 1998; 317:703-713.

  14. Aroca PR, Espeso Sentis O, Del Castillo DD. [Prospective study of correlation between diabetic retinopathy and microalbuminuria in diabetes type 1 patients]. Arch Soc Esp Oftalmol 2000; 75:307-314.

  15. Parving HH, Mogensen CE, Thomas MC y cols. Poor prognosis in proteinuric type 2 diabetic patients with retinopathy: insights from the RENAAL study. QJM 2005; 98:119-126.

  16. Asencio-Sánchez VM, García-Herrero E, Cabo-Vaquera V, García-Loygorri C. Microalbuminuria y retinopatía diabética. Arch Soc Esp Oftalmol 2007; 82:85-88.

  17. Parmar MS. Chronic renal disease. BMJ 2002; 325:85-90.

  18. Complicaciones microvasculares en la diabetes mellitus tipo 2. Rev Endocrin Nutri 2004; 12:S31-S44.

  19. Torres VA ZC. Nefropatía diabética. Rev Hosp Gral Dr M Gea González 2002; 5:24-32.

  20. Klein R, Knudtson MD, Lee KE y cols. The Wisconsin Epidemiologic Study of Diabetic Retinopathy XXIII: The Twenty-five-Year Incidence of Macular Edema in Persons with Type 1 Diabetes. Ophthalmology 2009.

  21. Knudsen ST, Bek T, Poulsen PL y cols. Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care 2002; 25:2328-2334.

  22. Ciardella AP. Partial resolution of diabetic macular oedema after systemic treatment with furosemide. Br J Ophthalmol 2004; 88:1224-1225.

  23. Klein R, Zinman B, Gardiner R y cols. The relationship of diabetic retinopathy to preclinical diabetic glomerulopathy lesions in type 1 diabetic patients: the Renin-Angiotensin System Study. Diabetes 2005; 54:527-533.

  24. Cueto-Manzano AM, Cortes-Sanabria L, Martínez-Ramírez HR y cols. Detection of early nephropathy in Mexican patients with type 2 diabetes mellitus. Kidney International 2005; 68(Supl 97): S40-S45.

  25. Lesso-Zamora J, Favier-González C, Viteri-Siso MS, Estrada-Rodríguez JL. Control sistémico de una población diabética al momento de su ingreso a un centro oftalmológico de referencia. Rev Mex Oftalmol 2009; 83:11-14.

  26. Rigalleau V, Lasseur C, Perlemoine C y cols. Estimation of glomerular filtration rate in diabetic subjects: Cockcroft formula or modification of Diet in Renal Disease study equation? Diabetes Care 2005; 28:838-843.

  27. Levey AS, Bosch JP, Lewis JB y cols. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130:461-470.

  28. Coresh J, Astor BC, Greene T y cols. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003; 41:1-12.




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