DME predicts renal failure in diabetic patients with CKD

Patients with diabetes mellitus (DM) and chronic kidney disease (CKD) are at greater risk of end-stage renal disease (ESRD), dialysis, and renal transplantation at 5 years if they also have diabetic macular edema (DME), reveals a study.

Data from 120 healthcare organizations in the TriNetX network were analysed in this retrospective cohort study. The researchers reviewed electronic medical records of nearly 90 million patients and classified them into DME and non-DME cohorts.

New-onset ESRD was the primary outcome, while all-cause mortality was secondary. Confounding effects were reduced by incorporating covariate factors.

Prior to matching, patients with DME were found to use more medications and have poorer renal function and blood sugar control relative to their non-DME counterparts.

The two cohorts were well-matched in demographics, lifestyle, comorbidities, medication usage, and socioeconomic status. However, the patients in the DME cohort showed a significantly higher risk of ESRD, dialysis, and renal implantation than those in the non-DME cohort.

These findings persisted in subgroup analysis regardless of follow-up duration, initial estimated glomerular filtration rate, or glycated haemoglobin levels. Notably, DME patients had a lower risk of all-cause mortality than those without DME.

“Statistically significant 5-year increased risks of ESRD, dialysis, and renal transplantation were observed in patients with concurrent DME,” the researchers said. “Therefore, close monitoring and follow-up of the renal function in DM patients with DME are necessary and strongly recommended.”