Individuals with type 1 diabetes (T1D) with chronic kidney disease (CKD) and proliferative diabetic retinopathy (PDR) may have a higher risk for cardiovascular disease (CVD) compared with those without PDR, according to a study published in Diabetes Care.
Researchers performed a cross-sectional study that included data from US residents (n=762) diagnosed with T1D for 50 years or longer (medalist study) and compared it with data from a replication cohort (n=675) from the longitudinal Finnish Diabetic Nephropathy Study (FinnDiane) to determine the relationships between CVD status and the presence of CKD and PDR.
CKD and PDR were defined as estimated glomerular filtration rate <45 mL/min/1.73m2 (CKD stage 3b) and according to the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol, respectively.
Characteristics of individuals from the medalist study specifically note a significantly older age at time of diabetes diagnosis in individuals with CKD but no PDR. The majority of individuals were female (55%), with an average age of 65 years and 53 years of diabetes. The prevalence of CKD, PDR, and CVD in individuals was found to be 12.9%, 53.3%, and 38.9%, respectively. Individuals from the medalists study were placed into the following 4 categories with the prevalence of CVD noted as follows:
CKD and no PDR (+CKD/-PDR) (n=30): CVD prevalence 34.5%
No CKD and no PDR (-CKD/-PDR) (n=327): CVD prevalence 28.8%
CKD and PDR (+CKD/+PDR) (n=66): CVD prevalence 68.2%
No CKD and PDR (-CKD/+PDR) (n=339): CVD prevalence 42.8%
Individuals from the FinnDiane study comprised a cohort of 45.2% female with an average age of 44.9 years, and an average length of time diagnosed with diabetes at 32.7 years. The prevalence of CKD, PDR, and CVD in individuals in this study was found to be 28.3%, 63.1%, and 18.1%, respectively. Individuals in this study were also placed into the same 4 categories as medalists study with the prevalence of CVD noted as follows:
+CKD/-PDR (n=21): CVD prevalence 19.1%
-CKD/-PDR (n=228): CVD prevalence 6.6%
+CKD/+PDR (n=170): CVD prevalence 37.1%
-CKD/+PDR (n=256): CVD prevalence 15.1%
Study results in medalist patients show the CVD prevalence rate to be half in +CKD/-PDR group compared with +CKD/+PDR group, with a further examination of covariates finding +CKD/-PDR group to be older at the time of diabetes diagnosis than those in the +CKD/+PDR group (average age of diagnosis 15 and 10 years, respectively P =.003). Also interesting…