title: The association between chronic kidney disease and diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008-2010.
abstract: OBJECTIVE
  To explore the relationship between chronic kidney disease and diabetic retinopathy in a representative population of Korean diabetic adults.
  
  
  METHODS
  We analyzed data from the Korea National Health and Nutrition Examination Surveys (2008-2010). A total of 15,409 individuals (weighted frequency, 32,168,636) aged 19 and over who completed ophthalmologic and renal functional examinations were evaluated. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate of < 60 ml/min/1.73 m2 or proteinuria greater than 1+. Seven standard photographs from the Early Treatment for Diabetic Retinopathy Study were obtained from each eye after pharmacological pupil dilatation. Diabetic retinopathy (DR) was defined as the presence of 1 or more retinal microaneurysms or retinal blot hemorrhages with or without more severe lesions. Vision-threatening diabetic retinopathy (VTDR) was defined as the presence of a clinically significant macular edema (CSME) or proliferative diabetic retinopathy.
  
  
  RESULTS
  CKD was significantly associated with DR and VTDR (odds ratio (OR), 95% confidence interval (CI); 2.49(1.43-4.35) and 3.74(1.56-8.95), respectively) in the diabetic population. After controlling for confounders, however, CKD was significantly associated only with DR [adjusted OR (aOR), 95% CI; 2.34(1.04-5.28)]. In the subgroup analysis for CKD, only proteinuria was significantly associated with DR and VTDR (aOR, 95% CI; 4.56(1.51-13.77) and 5.61(1.06-29.87), respectively) in this population.
  
  
  CONCLUSIONS
  Our results show that CKD appears to be associated with DR and VTDR in a Korean diabetic population. In particular, proteinuria, not decreased eGFR, is more significantly associated with DR or VTDR.
authors: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Young-Hoon
authors: YH
authors: Park
authors: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Jeong Ah
authors: JA
authors: Shin
authors: Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Jae-Hyung
authors: JH
authors: Han
authors: Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America.
authors: Yong-Moon
authors: YM
authors: Park
authors: Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Hyeon Woo
authors: HW
authors: Yim
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008269:Macular Edema / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D009749:Nutrition Surveys / Q000379:methods*; D011159:Population Surveillance / Q000379:methods; D011507:Proteinuria / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D005947:Glucose