Annals of medicine and surgery (2012) · 2025
Association between chronic kidney disease severity and retinopathy in hypertensive, diabetic, and mixed retinopathy in Nepal: a cross-sectional study.
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Prasai Gunjan, Shrestha Sabina, Shrestha Priyanka, Shakya Kiran, Agrawal Rupesh, Khatri Anadi
Аннотация
INTRODUCTION: Hypertensive, diabetic, and mixed retinopathies are prevalent ocular conditions that can serve as indicators of systemic diseases, particularly chronic kidney disease (CKD). The association between the severity of these retinopathies and the grading of CKD remains under-explored. This study aims to elucidate the correlation between the severity of hypertensive, diabetic, or mixed retinopathies and the stages of CKD, providing insights into the interconnected pathophysiology of these conditions.
METHODOLOGY: A cross-sectional study was conducted involving 100 patients diagnosed with hypertensive, diabetic, or mixed retinopathies. Participants were categorized based on their retinopathy type and severity using standardized grading systems. CKD staging was determined according to the kidney disease guidelines. Data were collected through comprehensive ophthalmic examinations, retinal imaging's and patient medical histories. Statistical analysis was performed to assess the association between retinopathy severity and CKD stages using odds ratio (OR).
RESULTS: The study found a significant positive correlation between the severity of retinopathies and the stages of CKD. Hypertensive Retinopathy with visual morbidity and complications was found to be associated with greater severity of CKD (OR = 2.98, P = 0.014). Patients with advanced CKD stages had more severe diabetic retinopathy compared to those with lesser severity with OR of 3.60 (P = 0.013). Mixed retinopathy had the strongest association with severity of CKD with OR of 9.07; P = 0.002).
CONCLUSION: The severity of hypertensive, diabetic, and mixed retinopathies correlates strongly with CKD progression. These findings highlight the need for integrated care models emphasizing regular ophthalmic and renal evaluations in at-risk populations. Early detection and management of retinopathies may facilitate timely intervention for CKD, reducing systemic disease burden.
METHODOLOGY: A cross-sectional study was conducted involving 100 patients diagnosed with hypertensive, diabetic, or mixed retinopathies. Participants were categorized based on their retinopathy type and severity using standardized grading systems. CKD staging was determined according to the kidney disease guidelines. Data were collected through comprehensive ophthalmic examinations, retinal imaging's and patient medical histories. Statistical analysis was performed to assess the association between retinopathy severity and CKD stages using odds ratio (OR).
RESULTS: The study found a significant positive correlation between the severity of retinopathies and the stages of CKD. Hypertensive Retinopathy with visual morbidity and complications was found to be associated with greater severity of CKD (OR = 2.98, P = 0.014). Patients with advanced CKD stages had more severe diabetic retinopathy compared to those with lesser severity with OR of 3.60 (P = 0.013). Mixed retinopathy had the strongest association with severity of CKD with OR of 9.07; P = 0.002).
CONCLUSION: The severity of hypertensive, diabetic, and mixed retinopathies correlates strongly with CKD progression. These findings highlight the need for integrated care models emphasizing regular ophthalmic and renal evaluations in at-risk populations. Early detection and management of retinopathies may facilitate timely intervention for CKD, reducing systemic disease burden.