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Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia

OBJECTIVE: Retinopathy is an established microvascular complication of type 2 diabetes mellitus (T2DM), but its independent relationship with macrovascular and other microvascular complications is less well defined across the spectrum of kidney disease in T2DM. We examined the prognostic value of re...

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Autores principales: Bello, Natalie A, Pfeffer, Marc A, Skali, Hicham, McGill, Janet B, Rossert, Jerome, Olson, Kurt A, Weinrauch, Larry, Cooper, Mark E, de Zeeuw, Dick, Rossing, Peter, McMurray, John J V, Solomon, Scott D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212578/
https://www.ncbi.nlm.nih.gov/pubmed/25452859
http://dx.doi.org/10.1136/bmjdrc-2013-000011
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author Bello, Natalie A
Pfeffer, Marc A
Skali, Hicham
McGill, Janet B
Rossert, Jerome
Olson, Kurt A
Weinrauch, Larry
Cooper, Mark E
de Zeeuw, Dick
Rossing, Peter
McMurray, John J V
Solomon, Scott D
author_facet Bello, Natalie A
Pfeffer, Marc A
Skali, Hicham
McGill, Janet B
Rossert, Jerome
Olson, Kurt A
Weinrauch, Larry
Cooper, Mark E
de Zeeuw, Dick
Rossing, Peter
McMurray, John J V
Solomon, Scott D
author_sort Bello, Natalie A
collection PubMed
description OBJECTIVE: Retinopathy is an established microvascular complication of type 2 diabetes mellitus (T2DM), but its independent relationship with macrovascular and other microvascular complications is less well defined across the spectrum of kidney disease in T2DM. We examined the prognostic value of retinopathy in assessing the risk of developing end-stage renal disease (ESRD), cardiovascular morbidity or death among patients in the Trial to Reduce cardiovascular Events with Aranesp Therapy (TREAT). DESIGN: TREAT enrolled 4038 patients with T2DM, chronic kidney disease (CKD) and moderate anemia. Patients were grouped by baseline history of retinopathy. Proportional hazards regression models were utilized to assess the association between retinopathy and subsequent ESRD, cardiovascular morbidity or death over an average of 2.4 years. RESULTS: Although younger, the 1895 (47%) patients with retinopathy had longer duration of diabetes, lower estimated glomerular filtration rate, more proteinuria, and more microvascular complications. In univariate analysis, retinopathy was associated with a higher rate of ESRD, but not with cardiovascular events or mortality. After adjustment, retinopathy was no longer statistically significant for the prediction of ESRD or any clinical endpoint. CONCLUSIONS: In a large cohort of patients with T2DM, CKD, and anemia, retinopathy was common but not independently associated with a higher risk of renal or cardiovascular morbidity or death. TRIAL REGISTRATION NUMBER: NCT00093015
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spelling pubmed-42125782014-12-01 Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia Bello, Natalie A Pfeffer, Marc A Skali, Hicham McGill, Janet B Rossert, Jerome Olson, Kurt A Weinrauch, Larry Cooper, Mark E de Zeeuw, Dick Rossing, Peter McMurray, John J V Solomon, Scott D BMJ Open Diabetes Res Care Cardiovascular and Metabolic Risk OBJECTIVE: Retinopathy is an established microvascular complication of type 2 diabetes mellitus (T2DM), but its independent relationship with macrovascular and other microvascular complications is less well defined across the spectrum of kidney disease in T2DM. We examined the prognostic value of retinopathy in assessing the risk of developing end-stage renal disease (ESRD), cardiovascular morbidity or death among patients in the Trial to Reduce cardiovascular Events with Aranesp Therapy (TREAT). DESIGN: TREAT enrolled 4038 patients with T2DM, chronic kidney disease (CKD) and moderate anemia. Patients were grouped by baseline history of retinopathy. Proportional hazards regression models were utilized to assess the association between retinopathy and subsequent ESRD, cardiovascular morbidity or death over an average of 2.4 years. RESULTS: Although younger, the 1895 (47%) patients with retinopathy had longer duration of diabetes, lower estimated glomerular filtration rate, more proteinuria, and more microvascular complications. In univariate analysis, retinopathy was associated with a higher rate of ESRD, but not with cardiovascular events or mortality. After adjustment, retinopathy was no longer statistically significant for the prediction of ESRD or any clinical endpoint. CONCLUSIONS: In a large cohort of patients with T2DM, CKD, and anemia, retinopathy was common but not independently associated with a higher risk of renal or cardiovascular morbidity or death. TRIAL REGISTRATION NUMBER: NCT00093015 BMJ Publishing Group 2014-04-06 /pmc/articles/PMC4212578/ /pubmed/25452859 http://dx.doi.org/10.1136/bmjdrc-2013-000011 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Cardiovascular and Metabolic Risk
Bello, Natalie A
Pfeffer, Marc A
Skali, Hicham
McGill, Janet B
Rossert, Jerome
Olson, Kurt A
Weinrauch, Larry
Cooper, Mark E
de Zeeuw, Dick
Rossing, Peter
McMurray, John J V
Solomon, Scott D
Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
title Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
title_full Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
title_fullStr Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
title_full_unstemmed Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
title_short Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
title_sort retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia
topic Cardiovascular and Metabolic Risk
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212578/
https://www.ncbi.nlm.nih.gov/pubmed/25452859
http://dx.doi.org/10.1136/bmjdrc-2013-000011
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