The Severity of Diabetic Retinopathy Is an Independent Factor for the Progression of Diabetic Nephropathy
Open accessAbstract
(1) Background: It has rarely been studied whether the severity of diabetic retinopathy (DR) could influence renal disease progression in end-stage renal disease (ESRD) and chronic kidney disease (CKD) in patients with type 2 diabetes. The aim of this study was to evaluate renal disease progression in ESRD and CKD according to DR severity in patients with type 2 diabetes. (2) Methods: We included 1329 patients and divided the cohort into two end-points. The first was to trace the incidence of ESRD in all enrolled participants and the other was to follow their progression to CKD. (3) Results: Significantly higher crude hazard ratios (HRs) of ESRD incidence in all enrolled participants were noted, and this ratio increased in a stepwise fashion. However, after adjustment, DR severity was not associated with ESRD events. Therefore, a subgroup of 841 patients without CKD was enrolled to track their progression to CKD. Compared with no diabetic retinopathy, the progression of CKD increased in a stepwise fashion, from mild nonproliferative diabetic retinopathy (NPDR) to moderate NPDR, to severe NPDR and to proliferative diabetic retinopathy (PDR), both in the crude and adjusted models. (4) Conclusions: The severity of retinopathy appeared to be associated with renal lesions and the development of CKD. Our findings suggest that the severity of DR is a risk factor for progression to CKD. Therefore, diabetic retinopathy is useful for prognosticating the clinical course of diabetic kidney disease.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Hypertension and dyslipidemia overlap with diabetic retinopathy and diabetic nephropathy.
“Comparative analyses across complications reveal differing key predictors: retinal imaging features are critical for DR [154], renal function indicators are highly specific to DN [155], while hypertension and dyslipidemia serve as strong predictors for CVD [156] but also overlap with DR and DN [157].”
From Artificial intelligence-powered prediction of diabetic complications: from clinical data to molecular omics (2026) · cites this paper as [157]
The Introduction (page not specified in our copy) identifies systolic hypertension as a risk factor shared by diabetic retinopathy and diabetic nephropathy. The Discussion says lipid-lowering therapy may reduce nephropathy risk, but the paper does not establish dyslipidemia as a factor shared by both complications. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 28 · Cited by 35
Research works printed but not linked: 23
- [1]The Diabetes Control and Complications (DCCT) Research Group Effect of intensive therapy on the development and progression of diabetic nephropathy in the diabetes control and complications trial Kidney Int. 1995 47 1703 1720 10.1038/ki.1995.236 7643540 · DOI · Paper page
- [2]Turner R.C. Holman R.R. Stratton I.M. Cull C.A. Matthews D.R. Manley S.E. Frighi V. Wright A.D. Neil A. Kohner E. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) Lancet 1998 352 854 865 9742977
- [3]Mathiesen E. Rønn B. Storm B. Foght H. Deckert T. The natural course of microalbuminuria in insulin-dependent diabetes: A 10-year prospective study Diabet. Med. 1995 12 482 487 10.1111/j.1464-5491.1995.tb00528.x 7648820 · DOI
- [4]Hung C.-C. Lin H.Y.-H. Hwang D.-Y. Kuo I.-C. Chiu Y.-W. Lim L.-M. Hwang S.-J. Chen H.-C. Diabetic retinopathy and clinical parameters favoring the presence of diabetic nephropathy could predict renal outcome in patients with diabetic kidney disease Sci. Rep. 2017 7 1 9 10.1038/s41598-017-01204-6 28432319 PMC5430840 · DOI
- [6]Park H.C. Lee Y.-K. Cho A. Hoon Han C. Noh J.-W. Shin Y.J. Bae S.H. Kim H. Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus PLoS ONE 2019 14 e0220506 10.1371/journal.pone.0220506 31356653 PMC6663021 · DOI
- [7]Rodriguez-Poncelas A. Mundet-Tuduri X. Miravet-Jimenez S. Casellas A. Barrot-De la Puente J.F. Franch-Nadal J. Coll-de Tuero G. Chronic kidney disease and diabetic retinopathy in patients with type 2 diabetes PLoS ONE 2016 11 e0149448 10.1371/journal.pone.0149448 26886129 PMC4757564 · DOI
- [8]Lin H.-T. Zheng C.-M. Wu Y.-C. Chang Y.-H. Chen J.-T. Liang C.-M. Chang T.-J. Zheng J.-Q. Tai M.-C. Lin Y.-F. Diabetic retinopathy as a risk factor for chronic kidney disease progression: A multicenter case–control study in Taiwan Nutrients 2019 11 509 10.3390/nu11030509 PMC6470494 30818841 · DOI
- [9]Yamanouchi M. Mori M. Hoshino J. Kinowaki K. Fujii T. Ohashi K. Furuichi K. Wada T. Ubara Y. Retinopathy progression and the risk of end-stage kidney disease: Results from a longitudinal Japanese cohort of 232 patients with type 2 diabetes and biopsy-proven diabetic kidney disease BMJ Open Diabetes Res. Care 2019 7 e000726 10.1136/bmjdrc-2019-000726 PMC6861100 31798893 · DOI
- [10]Wong T.Y. Sun J. Kawasaki R. Ruamviboonsuk P. Gupta N. Lansingh V.C. Maia M. Mathenge W. Moreker S. Muqit M.M.K. Guidelines on diabetic eye care: The international council of ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings Ophthalmology 2018 125 1608 1622 10.1016/j.ophtha.2018.04.007 29776671 · DOI · Paper page
- [11]Hogg R.J. Furth S. Lemley K.V. Portman R. Schwartz G.J. Coresh J. Balk E. Lau J. Levin A. Kausz A.T. National kidney foundation’s kidney disease outcomes quality initiative clinical practice guidelines for chronic kidney disease in children and adolescents: Evaluation, classification, and stratification Pediatrics 2003 111 1416 1421 10.1542/peds.111.6.1416 12777562 · DOI
- [14]Hu J. Shen L. Sun G. Squeeze-and-excitation networks Proceedings of the IEEE Conference on Computer Vision And Pattern Recognition Salt Lake City, UT, USA 18–23 June 2018 7132 7141
- [15]Simpson A.J. Over-sampling in a deep neural network arXiv 2015 1502.03648
- [16]LLin C. Hsu C.J. Lou Y.S. Yeh S.J. Lee C.C. Su S.L. Chen H.C. Artificial intelligence learning semantics via external resources for classifying diagnosis codes in discharge notes J. Med. Internet Res. 2017 19 e380 10.2196/jmir.8344 29109070 PMC5696581 · DOI
- [19]El-Asrar A.M.A. Al-Rubeaan K.A. Al-Amro S.A. Moharram O.A. Kangave D. Retinopathy as a predictor of other diabetic complications Int. Ophthalmol. 2001 24 1 11 10.1023/A:1014409829614 11998880 · DOI
- [20]Sasso F.C. Pafundi P.C. Gelso A. Bono V. Costagliola C. Marfella R. Sardu C. Rinaldi L. Galiero R. Acierno C.J.N. Relationship between albuminuric CKD and diabetic retinopathy in a real-world setting of type 2 diabetes: Findings from no blind study Nutr. Metab. Cardiovasc. Dis. 2019 29 923 930 10.1016/j.numecd.2019.05.065 31377186 · DOI
- [21]Jadawji C. Crasto W. Gillies C. Kar D. Davies M.J. Khunti K. Seidu S. Prevalence and progression of diabetic nephropathy in South Asian, white European and African Caribbean people with type 2 diabetes: A systematic review and meta-analysis Diabetes Obes. Metab. 2019 21 658 673 10.1111/dom.13569 30407709 · DOI
- [22]Wei L. Xiao Y. Li L. Xiong X. Han Y. Zhu X. Sun L. The Susceptibility genes in diabetic nephropathy Kidney Dis. 2018 4 226 237 10.1159/000492633 PMC6276750 30574499 · DOI
- [23]Bello N.A. Pfeffer M.A. Skali H. McGill J.B. Rossert J. Olson K.A. Weinrauch L. Cooper M.E. de Zeeuw D. Rossing P. Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia BMJ Open Diabetes Res. Care 2014 2 e000011 10.1136/bmjdrc-2013-000011 PMC4212578 25452859 · DOI
- [24]Penno G. Solini A. Zoppini G. Orsi E. Zerbini G. Trevisan R. Gruden G. Cavalot F. Laviola L. Morano S. Rate and determinants of association between advanced retinopathy and chronic kidney disease in patients with type 2 diabetes: The Renal Insufficiency And Cardiovascular Events (RIACE) Italian multicenter study Diabetes Care 2012 35 2317 2323 10.2337/dc12-0628 23093684 PMC3476898 · DOI
- [25]Cooper M.E. Pathogenesis, prevention, and treatment of diabetic nephropathy Lancet 1998 352 213 219 10.1016/S0140-6736(98)01346-4 9683226 · DOI
- [26]Gross J.L. De Azevedo M.J. Silveiro S.P. Canani L.H. Caramori M.L. Zelmanovitz T. Diabetic nephropathy: Diagnosis, prevention, and treatment Diabetes Care 2005 28 164 176 10.2337/diacare.28.1.164 15616252 · DOI · Paper page
- [27]Ruiz-Ortega M. Rodrigues-Diez R.R. Lavoz C. Rayego-Mateos S. Special Issue “Diabetic Nephropathy: Diagnosis, Prevention and Treatment” Multidisciplinary Digital Publishing Institute Basel, Switzerland 2020 PMC7141346 32192024
- [28]Bello A.K. Alrukhaimi M. Ashuntantang G.E. Bellorin-Font E. Gharbi M.B. Braam B. Feehally J. Harris D.C. Jha V. Jindal K. Global overview of health systems oversight and financing for kidney care Kidney Int. Suppl. 2018 8 41 51 10.1016/j.kisu.2017.10.008 30675438 PMC6336220 · DOI
- Authors
- Hsing, S.-C., Lee, C.-C., Lin, C., Chen, J.-T., Chen, Y.-H., & Fang, W.-H.
- Affiliations
- Tri-Service General Hospital (TW)
- National Defense Medical Center (TW)
- Corresponding author
- Fang, Wen-Hui
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2020-12-22
- Volume
- 10
- Issue
- 1
- Pages
- 3
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC7792601
- OpenAlex
- W3115539147
- Cited by
- 35
- References
- 28
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 12 · 2021: 2
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Science and Technology, Taiwan (MOST 109, MOST109-2314-B016-021, MOST 108-3111-Y-016-009, MOST108-2314-B016-001, MOST 109-3111-Y-016-002, MOST 108-, MOST109-2314-B016-026)
- 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, diabetic nephropathy, type 2 diabetes, chronic kidney disease progression, end-stage renal disease, retinopathy severity, proliferative diabetic retinopathy, non-proliferative diabetic retinopathy, prognostic factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
