Journal Article

Diabetic retinopathy in predicting diabetic nephropathy in patients with type 2 diabetes and renal disease: a meta-analysis

Huang, F. X., He, F., Yu, X. Q., Wu, X. F., Xia, X.

2013

Overview

Aims/hypothesis The aim of this meta-analysis is to determine the predictive value of diabetic retinopathy in differentiating diabetic nephropathy from non-diabetic renal diseases in patients with type 2 diabetes and renal disease. Methods Medline and Embase databases were searched from inception to February 2012. Renal biopsy studies of participants with type 2 diabetes were included if they contained data with measurements of diabetic retinopathy. Pooled sensitivity, specificity, positive predictive value, negative predictive value and other diagnostic indices were evaluated using a random-effects model. Results The meta-analysis investigated 26 papers with 2012 patients. The pooled sensitivity and specificity of diabetic retinopathy to predict diabetic nephropathy were 0.65 (95% CI 0.62, 0.68) and 0.75 (95% CI 0.73, 0.78), respectively. The pooled positive and negative predictive value of diabetic retinopathy to predict diabetic nephropathy were 0.72 (95% CI 0.68, 0.75) and 0.69 (95% CI 0.67, 0.72), respectively. The area under the summary receiver operating characteristic curve was 0.75, and the diagnostic odds ratio was 5.67 (95% CI 3.45, 9.34). For proliferative diabetic retinopathy, the pooled sensitivity was 0.25 (95% CI 0.16, 0.35), while the specificity was 0.98 (95% CI 0.92, 1.00). There was heterogeneity among studies ( p <  0.001), and no publishing bias was identified. Conclusions/interpretation Diabetic retinopathy is useful in diagnosing or screening for diabetic nephropathy in patients with type 2 diabetes and renal disease. Proliferative diabetic retinopathy may be a highly specific indicator for diabetic nephropathy.

• Publisher: Springer-Verlag,Springer,Springer Nature B.V
• Subject: Associated diseases and complications / Biological and medical sciences / Biopsy / Diabetes / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - epidemiology / Diabetes. Impaired glucose tolerance / Diabetic Nephropathies - diagnosis / Diabetic Nephropathies - epidemiology / Diabetic nephropathy / Diabetic retinopathy / Diabetic Retinopathy - diagnosis / Diabetic Retinopathy - epidemiology / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / Etiopathogenesis. Screening. Investigations. Target tissue resistance / Human Physiology / Humans / Internal Medicine / Kidney diseases / Kidney Diseases - complications / Kidney Diseases - epidemiology / Kidneys / Medical sciences / Medicine / Medicine & Public Health / Meta-Analysis / Metabolic Diseases / Nephrology. Urinary tract diseases / Ophthalmology / Pathology / Retinopathies / Urinary system involvement in other diseases. Miscellaneous