English

Abstract

BACKGROUND In diabetes mellitus microvascular damages at various end-organ frequently occurs and leads to development of diabetic nephropathy as well as diabetic retinopathy. Diabetic nephropathy ultimately causes end stage renal disease. Diabetic retinopathy even at its earlier stage is easily suspected by simple clinical examination in any ophthalmological clinic. We wanted to study the relationship between various stages of diabetic retinopathy with diabetic nephropathy. METHODS 1209 diagnosed patients of diabetic mellitus were screened for presence of diabetic retinopathy. First comprehensive ophthalmological examination including slit-lamp bimicroscopy and indirect ophthalmoscopy were done and then clinically typing of diabetic retinopathy according to ETDRS classification was done. Then all diagnosed case of diabetic retinopathy further examined for blood Glycosylated haemoglobin, blood urea and serum creatinine to detect diabetic nephropathy. RESULTS 273 patients were included in this study. Average age of patients was 64.6 years with mean duration of diabetes mellitus was 7.4 years. Patients suffering from severe NPDR and PDR had association with poor control of blood glycosylated haemoglobin. Patients with mild NPDR 31.1 %, Moderate NPDR 52.3 %, severe NPDR 67.4 % and in PDR 65.2 % patient had blood urea more than 40 mg / dl. In mild NPDR group 32.2 %, moderate NPDR 55.4 %, severe NPDR 67.4 % and in PDR group 63.9 % patients had serum creatinine more than 1.5 mg / dl. We have found statistically significant correlation between HbA1c level and severity of diabetic retinopathy. Prevalence of nephropathy increased with increments in the grade of retinopathy. CONCLUSIONS A significant number of patients with severe NPDR or PDR had increased blood urea and serum creatinine level. Clinical grading of diabetic retinopathy gives us a clue about the presence of diabetic nephropathy. As diagnosis of diabetic retinopathy is simple and straight forward clinical procedure and it can be done all ophthalmological se up, we recommend all patient with diabetic retinopathy must be screened for nephropathy. KEYWORDS Diabetic Retinopathy, Diabetic Nephropathy, Glycosylated Haemoglobin, Blood Urea, Serum Creatinine