Albuminuria as a risk factor for diabetic retinopathy in indonesian type 2 diabetes mellitus patients

Soebagijo Adi Soelistijo; Deasy Ardiany; Robert Dwitama Adiwinoto; Agung Pranoto; Sauli Ari Widjaja

Soebagijo Adi Soelistijo Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, Airlangga University Faculty of Medicine-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Deasy Ardiany Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, Airlangga University Faculty of Medicine-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Robert Dwitama Adiwinoto Department of Internal Medicine, Airlangga University Faculty of Medicine-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Agung Pranoto Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, Airlangga University Faculty of Medicine-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Sauli Ari Widjaja Department of Ophthalmology, Division of Vitreo-retina, Airlangga University Faculty of Medicine-Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Keywords: diabetic retinopathy, diabetic nephropathy, albuminuria, type 2 diabetes

Abstract

Diabetic retinopathy (DR) is the leading cause of new-onset blindness in productive age. The aim of the study is to investigate the clinical relevance of albuminuria as a risk factor for DR in Indonesian Type 2 Diabetes Mellitus (T2DM) patients, as both have similar pathogenesis and are closely related. A number of 168 adult T2DM patients in the diabetes outpatient clinic at the Dr. Soetomo General Academic Hospital were recruited from July to December 2019 for this cross-sectional study. All participants underwent complete history taking and physical examination. A comprehensive metabolic panel and urinalysis parameters were collected from all subjects. Bivariate analysis with the chi-square test was used, followed by multivariate analysis by logistic regression. Albuminuria and DR were present in 125 subjects (74.4%) and 80 subjects (47.6%) respectively. There was a statistically significant difference in the prevalence of albuminuria between the group with and without DR (p=0.000). Through multivariate logistic regression, the presence of albuminuria increased the risk for DR 4.857 folds (95% CI: 2.029–11.626; p=0.000) adjusted for age, sex, BMI, systolic blood pressure, diastolic blood pressure, HbA1c levels, and dyslipidemia. In conclusion, albuminuria increases the risk of developing DR in Indonesian T2DM patients.