Diabetic retinopathy severity is associated with renal function deterioration in patients with diabetic kidney disease: a retrospective cohort study.

PDR and NPDR were each independently associated with approximately threefold greater risk of renal function deterioration compared to absent DR.

• Cox regression adjusted for age, BMI, HbA1c, LDL-C, systolic blood pressure, baseline eGFR, baseline UACR stage, SGLT2 inhibitor use, DM duration, RAS inhibitor use, and GLP-1RA use
• PDR: adjusted HR = 2.88; 95% CI: 1.08–7.71; p = 0.035
• NPDR: adjusted HR = 2.78; 95% CI: 1.004–7.70; p = 0.049
• The outcome was defined as eGFR decline (%) >15% over a 5-year follow-up period

A significant difference in eGFR decline was found across the absent DR, NPDR, and PDR groups.

• P = 0.024 for the difference in eGFR decline (%) between the absent DR, NPDR, and PDR groups
• Study included 140 patients with DKD, of whom 101 had eGFR parameters available during follow-up
• Mean follow-up time was 34.31 (± 16.36) months

Patients with hard exudates (HEs) had more severe eGFR decline than those without HEs in unadjusted analysis.

• eGFR decline (%) was significantly more severe in patients with HEs than in those without HEs (P = 0.011)
• HEs were identified via optical coherence tomography (OCT)

The presence of hard exudates was not independently associated with renal function deterioration after multivariable adjustment.

• In the adjusted Cox regression model, HEs were not independently associated with renal function deterioration (P = 0.567)
• Adjustment covariates included age, BMI, HbA1c, LDL-C, systolic blood pressure, baseline eGFR, baseline UACR stage, SGLT2 inhibitor use, DM duration, RAS inhibitor use, and GLP-1RA use

The study was designed as a retrospective cohort study of patients with diabetic kidney disease with a defined renal deterioration outcome.

• 140 patients with DKD were included; 101 had eGFR parameters during follow-up
• DR was categorized into nonproliferative DR (NPDR) and proliferative DR (PDR)
• The primary outcome was progression of DKD defined as eGFR decline (%) >15% over a 5-year follow-up period
• Clinical and laboratory data were acquired from medical records