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Cited by 4Chronic Kidney Disease and DiabetesRetinal Diseases and TreatmentsDiabetes Management and Research

Association of Diabetic Retinopathy with Chronic Kidney Disease Progression in Latinos with Type 2 Diabetes

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Figueroa, Ariel E., Roy, Neil, Millan-Ferro, Andreina, Silva, Paolo S., Rosas, Sylvia E.·2023·Ethnicity and Disease
DOI 10.18865/1683PMC PMC11152147
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Abstract

Aims: Diabetes remains a leading cause of blindness and kidney failure in the United States. Latinos are at increased risk for type 2 diabetes, and microvascular complications such as diabetic retinopathy (DR) and chronic kidney disease (CKD). We evaluated the association of DR with decline in kidney function in Latinos with type 2 diabetes with or without CKD in a multispecialty clinic. Methods: This is a retrospective cohort study of 351 self-identified Latino individuals with type 2 diabetes enrolled in the Latino Diabetes Initiative at Joslin Diabetes Center. Baseline demographic factors including age, sex, comorbidities, and laboratory values such as A1c and albuminuria were evaluated as predictors of kidney outcomes. The annualized change in estimated glomerular filtration rate (eGFR) was evaluated with a linear regression model. We used logistic regression to evaluate whether DR was associated with development of rapid progressors (>3 mL/min/y eGFR loss) and 30% change in eGFR per year. Results: DR was present in 39.2% of the cohort with mild nonproliferative DR (NPDR) in 57.1%, moderate to severe NPDR in 27.8%, and proliferative DR in 15.0%. Those with DR had a longer duration of type 2 diabetes (P<.001), higher albuminuria (P=.003), and lower baseline eGFR (P=.001). We found that individuals with moderate to severe NPDR and proliferative DR had a significant decline in GFR (coefficient −6.32; 95% CI, −11.40 to −1.23) and −7.82 (−14.99 to −0.65), compared with individuals without DR. Conclusions: The presence of DR is a marker for increased eGFR loss, emphasizing the need for routine retinal examinations as part of comprehensive diabetes care. Individuals with DR should be considered at high risk for GFR loss.

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  • Patients diagnosed with hypertension are at higher risk for poor visual outcomes.

    “Patients diagnosed with kidney disease, hypertension, and covered under Medicaid insurance are at higher risk for poor visual outcomes13–24.”

    From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [22]

    Table 1 (Materials and Methods; page unavailable) shows higher mean systolic blood pressure in groups with more severe diabetic retinopathy, with a between-group P value of .02. But the paper does not show that patients diagnosed with hypertension have a higher subsequent risk of poor visual outcomes; its main outcome is kidney-function decline. (LLM, conf=0.79)

    Experimental — accuracy not yet measured

  • Patients diagnosed with kidney disease are at higher risk for poor visual outcomes.

    “Patients diagnosed with kidney disease, hypertension, and covered under Medicaid insurance are at higher risk for poor visual outcomes13–24.”

    From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [22]

    Table 2 (Materials and Methods; page unavailable) shows that CKD was more common among Latino patients with more severe diabetic retinopathy. The Discussion explains that advanced retinopathy can lead to vision loss, but the study did not measure visual outcomes or establish that a kidney disease diagnosis predicts them. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Patients covered under Medicaid insurance are at higher risk for poor visual outcomes.

    “Patients diagnosed with kidney disease, hypertension, and covered under Medicaid insurance are at higher risk for poor visual outcomes13–24.”

    From Autonomous AI-assisted diabetic retinopathy screening at primary care is associated with increased presentation to eye care by at risk patients (2026) · cites this paper as [22]

    The Introduction (page not provided) discusses diabetic retinopathy and vision loss, while the Discussion (page not provided) addresses retinopathy as a marker of kidney-function decline. Searches for “Medicaid,” insurance coverage, and visual outcomes found no passage linking Medicaid coverage to poor visual outcomes. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Sorted by citations

Authors
Figueroa, A. E., Roy, N., Millan-Ferro, A., Silva, P. S., & Rosas, S. E.
Affiliations
  • Joslin Diabetes Center (US)
  • 2 Latino Diabetes Initiative, Joslin Diabetes Center, Boston, MA
Corresponding author
Rosas, Sylvia E.
ORCID
Venue
Ethnicity and Disease
Publisher
Ethnicity and Disease Inc
Published
2023-01-01
Volume
33
Issue
1
Pages
9-16
ISSN
  • 1049-510X (ISSN-L)
  • 1945-0826
DOI
10.18865/1683
PMC
PMC11152147
OpenAlex
W4362563473
Cited by
4
References
2
Citations by year
2026: 2 · 2025: 1 · 2024: 1
FWCI
0.78
Type
journal article
Language
en
Open access
Locations
  • Ethnicity & Disease (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (UL1TR002541)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetic retinopathy, chronic kidney disease progression, type 2 diabetes, Hispanic Americans, estimated glomerular filtration rate decline, albuminuria, non-proliferative diabetic retinopathy, proliferative diabetic retinopathy, diabetic microvascular complications, retinal examination
MeSH terms
Adult, Aged, Albuminuria, Diabetes Mellitus, Type 2, Diabetic Retinopathy, Female, Glomerular Filtration Rate, Hispanic or Latino, Humans, Male, Middle Aged, Retrospective Studies, United States, Disease Progression, Renal Insufficiency, Chronic

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