Renal cortex echogenicity increases degree of retinopathy in diabetes mellitus

Main Article Content

Indah Maulidawati
Abdurrahim Rasyid Lubis
Dharma Lindarto

Abstract

Background
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.

Methods
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.

Results
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).

Conclusion
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.

Article Details

How to Cite
Maulidawati, I., Lubis, A. R., & Lindarto, D. (2016). Renal cortex echogenicity increases degree of retinopathy in diabetes mellitus. Universa Medicina, 35(1), 19–25. https://doi.org/10.18051/UnivMed.2016.v35.19-25
Section
Original Articles

References

Perkumpulan Endokrinologi Indonesia. Konsensus pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. Jakarta: PB PERKENI; 2011.

Lubis HR. Penyakit ginjal diabetik. Dalam: Setiati S, editor. Buku ajar ilmu penyakit dalam. Edisi VI, Jilid II. Jakarta: Interna Publishing;2014. Hal. 2102-5.

Moghazi S, Jones E, Schroepple J, et al. Correlation of renal histopathology with sonographic findings. Kidney Int 2005;67:1515-20.

Araújo N, Rioja L, Rebelo M. A clinical predictor index for renal survival. J Bras Nefrol 2010;32: 27-32.

American Academy of Ophthalmology Retina/Vitreous Panel. Preferred practice pattern guidelines : diabetic retinopathy. San Francisco (CA): American Academy of Ophthalmology; 2014.

Aroca PR , Ballart JF, Soler N, et al. Review of the relationship between renal and retinal microangiopathy in type 1 diabetes mellitus patients. Curr Diabetes Rev 2010;6:88-101.

Klein R, Zinman B, Gardiner R, et al. The relationship of diabetic retinopathy to preclinical diabetic glomerulopathy lesions in type 1 diabetic patients: the renin-angiotensin system study. Diabetes 2005;54:527–33.

Al Wakee JS, Hammad D, Al Suwaida A, et al. Microvascular and macrovascular complications in diabetic nephropathy patients referred to nephrology clinic. Saudi J Kidney Dis Transplant 2009;20:77-85.

Tervaert T, Mooyaart A, Amann K, et al. Pathologic classification of diabetic nephropathy. J Am Soc Nephrol 2010;21:556–63.

Roshan B, Stanton RC. A story of microalbuminuria and diabetic nephropathy. J Nephropathol 2013;2: 234–40.

Quaia E, editor. Radiological imaging of the kidney. Berlin: Springer Verlag;2011.

Rani PK, Rama R, Gupt A, et al. Albuminuria and diabetic retinopathy in type 2 diabetes mellitus Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 12). Diabetol Metab Syndr 2011; 3:1-8.

Chen YH, Chen HS, Tang DC. More impact of microalbuminuria on retinopathy than moderately reduced GFR among type 2 diabetic patients. Diabetes Care 2012;35:803–8.

Kundu D, Osta M, Mandal T, et al. Serum magnesium levels in patients with diabetic retinopathy. J Nat Sci Biol Med 2013;4:113–6.

Inassi J, Vijayalakshmy R. Role of duration of diabetes in the development of nephropathy in type 2 diabetic patients. Nat J Med Res 2013;3:5-8.

Chowta NK, Pant P, Chowta MN. Microalbuminuria in diabetes mellitus: association with age, sex, weight, and creatinine clearance. Indian J Nephrol 2009;19:53–6.

Java A, Kcomt J, Fonseca V. Diabetic nephropathy and retinopathy. Med Clin N Am 2004;88:1001–36.

Thomas RL, Dunstan F, Luzio SD, et al. Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the diabetic retinopathy screening service for Wales: retrospective analysis. BMJ 2012;344:e874.

Ng ZX, Chua KH, Tajunisah I, Pendek R, Kuppusamy UR. Attenuated levels of pro-inflammatory markers in diabetic retinopathy patients undergoing treatment with antihyperglycemic and antihypertensive drugs. Clinics 2013;68:185-91.

Samatha P, Venkateswarlu M, Prabodh S. Role of biochemical markers in the prediction of microvascular complications in type-2 diabetes mellitus. J Clin Diagn Res 2011;5:1154-7.