Diabetic retinopathy and its association with low glomerular filtration rate: a cross-sectional analysis of diabetes patients of community clinics across India

To determine the prevalence of diabetic retinopathy (DR) in patients with T2DM having low estimated glomerular filtration rate (eGFR). A cross-sectional retrospective data analysis of T2DM patients’ records who were screened for DR across Apollo Sugar Clinics from June 2016 to December 2016. DR was diagnosed through fundus examination; patients having eGFR values were grouped into eGFR < 60 and eGFR ≥ 60 mg/ml/1.73 m2. Appropriate statistical tests were applied to identify the association of eGFR and DR, and significance was set at 2-tailed p ≤ 0.05. A total of 1547 T2DM patients were screened; mean (SD) age was 56.7 (10.0) years. Among them, data of 443 patients with eGFR were included in the analysis. Mean eGFR was 91.2 mg/ml/1.73 m2; 12.5% patients had eGFR ≤ 60 mg/ml/1.73 m2 and 87.5% had ≥ 60 mg/ml/1.73 m2. DR was observed in 79 (17.8%) patients; it was higher in males (62%) than in females (38%). Further, the proportion of patients with DR was significantly higher in patients with eGFR ≤ 60 mg/ml/1.73 m2 compared with that in patients with eGFR ≥ 60 mg/ml/1.73 m2 (38% vs. 15%; p < 0.001). Association of DR with low eGFR in patients with T2DM may suggest presence of diabetes kidney disease in a community, thus reaffirming the significance of DR screening in community diabetes practices.