Renal disease and diabetic retinopathy
- ~40% people with retinopathy will have renal (kidney) disease Prakash
- ~50% of people with renal disease have retinopathy Prakash
- every aspect of diabetic control that prevents retinopathy, also prevents kidney disease; intesive glucose control prevents retinopathy; prevents nephropathy DCCT 2011
- patients with proteinuria (early kidney disease) need a low blood pressure of 115mmHg systolic to stabilise it..this will help protect the eyes. Such a low blood pressure may cause dizziness etc...so in practice blood pressure may need to be a little higher.
- erythropoietin (EPR) is a drug given in patients with kidney disease to treat anaemia... may increase retinopathy
prevalence and severity of proliferative retinopathy appear to have
increased and are most closely associated with the erythropoietin dosing'.
(I wonder if this effect is due to its effect on blood pressure).
- ARB and ACE drugs protect the kidneys....and they help to prevent retinopathy
- Macular oedema case 56
- Retinopathy is worse in renal disease Arch 2012 'suggesting that retinovascular pathology reflects renal disease.'