Retinopatía diabética como factor predictor de la disfunción renal en pacientes diabéticos tipo 2
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2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: La diabetes mellitus (DM) es una enfermedad endócrina con múltiples complicaciones. La nefropatía diabética (ND) es una de las más temidas ya que es la causa más frecuente de insuficiencia crónica terminal, patología de gran frecuencia en pacientes con DM tipo 2 (DM 2). Generalmente su diagnóstico es tardío por la falta de herramientas predictivas. La retinopatía diabética (RD) es una complicación presente en pacientes con DM y puede ayudar en el estudio de la ND. Objetivos: Establecer la existencia de correlación entre el grado de retinopatía diabética y el grado de función renal en pacientes con DM 2. Metodología: Se realizó un estudio transversal en el que se incluyeron de manera no aleatoria 36 pacientes con DM 2, RD y ND atendidos en el hospital Teodoro Maldonado Carbo – Guayaquil, que consintieron informadamente su participación. Resultados: el tiempo de padecimiento de DM y valores de hemoglobina glicosilada se asociaron significativamente con los estadíos de RD y de microalbuminuria (P 0.000). Los estadios más leves de la RD se observaron en los estadíos de microalbuminuria menos severos (RDNP leve 23,1% para A2 y 72,7% para A1). Los estadios más severos de RD tienen más casos de microalbuminuria de más de 300 mg/dl (RDNP severa 100% y RDP 100% en A3) (P 0,0000) Conclusiones: Existe una correlación directamente proporcional entre severidad de RD y la severidad de la microalbuminuria en pacientes con DM 2, lo que apoya la evidencia de que la RD predice la función renal.
Background: Diabetes mellitus (DM) is an endocrine disease with multiple complications. Diabetic nephropathy (DN) is one of the most feared because it is the most frequent cause of chronic terminal insufficiency, a pathology of great frequency in patients with type 2 DM (DM 2). Generally its diagnosis is delayed due to the lack of predictive tools. Diabetic retinopathy (DR) is a complication present in patients with DM and can help in the study of the DN. Objectives: To establish the existence of a correlation between the degree of diabetic retinopathy and the degree of renal function in patients with DM 2. Methodology: A cross-sectional study was conducted in which 36 patients with DM 2, RD were included in a non-randomized manner. and DN attended at the Teodoro Maldonado Carbo Hospital from Guayaquil, who consented informedly their participation. Results: DM disease time and glycosylated hemoglobin values were significantly associated with DR and microalbuminuria stages (P 0.000). The milder stages of DR were observed in less severe stages of microalbuminuria (mild NPDR 23.1% for A2 and 72.7% for A1). The most severe stages of DR have more cases of microalbuminuria of more than 300 mg / dl (severe RDNP 100% and PDR 100% in A3) (P 0.0000) Conclusions: There is a directly proportional correlation between RD severity and severity of microalbuminuria in patients with DM 2, which supports the evidence that RD predicts renal function.
Background: Diabetes mellitus (DM) is an endocrine disease with multiple complications. Diabetic nephropathy (DN) is one of the most feared because it is the most frequent cause of chronic terminal insufficiency, a pathology of great frequency in patients with type 2 DM (DM 2). Generally its diagnosis is delayed due to the lack of predictive tools. Diabetic retinopathy (DR) is a complication present in patients with DM and can help in the study of the DN. Objectives: To establish the existence of a correlation between the degree of diabetic retinopathy and the degree of renal function in patients with DM 2. Methodology: A cross-sectional study was conducted in which 36 patients with DM 2, RD were included in a non-randomized manner. and DN attended at the Teodoro Maldonado Carbo Hospital from Guayaquil, who consented informedly their participation. Results: DM disease time and glycosylated hemoglobin values were significantly associated with DR and microalbuminuria stages (P 0.000). The milder stages of DR were observed in less severe stages of microalbuminuria (mild NPDR 23.1% for A2 and 72.7% for A1). The most severe stages of DR have more cases of microalbuminuria of more than 300 mg / dl (severe RDNP 100% and PDR 100% in A3) (P 0.0000) Conclusions: There is a directly proportional correlation between RD severity and severity of microalbuminuria in patients with DM 2, which supports the evidence that RD predicts renal function.
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Nefropatías diabéticas, Retinopatía diabética, Dagnóstico, Oftalmología, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador