Relationship of proliferative diabetic retinopathy and severe stages of chronic renal failure

Abstract

Diabetic nephropathy, as a frequent complication in patients with diabetes mellitus (DM), is increasing due to the rapid increase in the prevalence of diabetes, which is considered one of the leading causes of chronic renal failure (CRF). Diabetic retinopathy (DR) and diabetic nephropathy are the two main microvascular complications of DM. Studies show that the prevalence and severity of visual pathology is significantly higher among patients with severe stages of CRF, which is associated with the following risk factors: hypertension, metabolic disorders, uremia, anemia, and the use of anticoagulant therapy. The leading forms of eye pathology in patients with DR and CRF are proliferative DR, macular edema, and vitreous hemorrhage. The main structural changes in the choroid and retina in patients with CRF are the thickness of the choroid, accompanied by a decrease in the density of vessels and the volume of perfusion in the surface capillary layer of the choriocapillaries, which is aggravated with the aggravation of the stage of the disease and is interconnected with impaired renal function. Literature data indicate a positive effect of the hemodialysis procedure on DR. It should be borne in mind that in patients with end-stage chronic renal failure, a hemodialysis session may be accompanied by pain in the eye associated with an increase in blood pressure. Interdisciplinary collaboration between nephrologists and ophthalmologists will ensure improved and adequate treatment of patients with CRF and proliferative DR.