ASSESMENT OF THE ASSOCIATION OF KIDNEY FUNCTION WORSENING AND DIABETIC RETINOPATHY SEVERITY IN PATIENTS ON FOLLOW UP, AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA.

Abstract

SUMMARY Background: Diabetic nephropathy (DN) and diabetic retinopathy (DR) are both complications of diabetic microangiopathy with similar pathogenesis and clinical relevance. Many literatures have shown the clear association of creatinine and eGFR worsening with presence and severity of retinopathy. There is paucity of evidence if this holds true in African setting and more in Ethiopia Objective: To assess the association of serum creation and estimated GFR worsening with diabetic retinopathy severity among type 2 DM patients on follow up at adult Endocrine, Nephrology and ophthalmology clinic, of St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: An Institution based cross-sectional study was conducted through chart review among type 2 DM with diabetic retinopathy patients attending adult Endocrine, nephrology and ophthalmology clinic of Saint Paul’s Hospital Millennium Medical College. A total of 384 patients were planned and 365 participants were involved making a response rate of 95.1%. Data were collected by structured questionnaire focusing on serum creation value and documented diabetic retinopathy severity by chart reviewing. Data was entered and analyzed using SPSS version 26. The result was explained using frequencies of variables, descriptive statistics including mean and standard deviation. Associations between dependent and independent variables were assessed by using binary and multiple logistic regressions using 95%CI and a p-value <0.05 at multivariate logistic regression stated as statistically significant. Result: - In this study 41.9% of the study participants had proliferative stage of diabetic retinopathy. On the other had the multivariate logistic regression revealed that male (AOR=2.9, 1.41, 6.01), unstable creatinine (AOR=3.5, 95%CI=1.97, 12.53) and estimated GFR <60 (AOR=29.9, 95%CI=14.38, 62.1) were a significant relation with diabetic retinopathy. Conclusion and recommendation: - serum creation and estimated glomerular filtration rate worsening were a significant association with progression of diabetic retinopathy. This study showed clear/no association between Cr and GFR worsening and severity of DR. it is good to screen for severity of diabetic retinal change just because of Cr and GFR worsening.