Question 1: What is the link between renal diseases and diabetes?

Type 2 diabetes mellitus is the most common single disease causing end-stage renal disease (ESRD) leading up to hemodialysis. Evidence suggest that almost 40% of patients requiring renal replacement therapy have diabetic nephropathy. Patients with type 2 diabetes mellitus on hemodialysis show a higher prevalence of comorbidities and poorer outcome in comparison to nondiabetic patients on dialysis.

Question 2: What is the link between retinopathy and diabetes?

Diabetic retinopathy is a common result of diabetes mellitus. It is one of the main reasons for blindness in the Western hemisphere. Even though diabetic retinopathy is not life-threatening, it has a huge impact on the quality of life of the diabetes patients. It is considered to be the most prevalent cause for blindness in working age people in developed countries.

Question 3: How are diabetes retinopathy and dialysis correlated?

Even though the prevalence is variable, a large number of diabetes patients on dialysis have retinopathy. The high frequency rate of diabetic retinopathy in hemodialysis patients suggests that there may be a common pathophysiological denominator of changes in retinal and renal vessels.

Question 4: Is there any link with smoking?

There is no evidence linking smoking habits (current smoker, former smoker, nonsmoker) with diabetic retinopathy, which could be due to unadmitted smoking. Even though it is very well known that cigarette smoking is an established risk factor for atherosclerotic diseases and the progression of diabetes mellitus, but there is no clarity about the association between diabetic retinopathy and cigarette smoking.

Question 5: What is the role of inflammation in diabetic retinopathy?

It is already known local inflammation in the eye plays a significant role in the development of diabetic retinopathy. Several intravitreal factors were found to be elevated in patients having diabetic retinopathy. Systemic inflammatory factors such as higher C-reactive protein (CRP) levels, increased leukocyte counts are related to more severe diabetic retinopathy. Usually, high inflammatory level drives often increase or severe diabetic retinopathy. There is an increased probability that subclinical inflammation contributes to diabetic retinopathy.

Resource:

Müller M, Schönfeld CL, Grammer T, et al. Risk factors for retinopathy in hemodialysis patients with type 2 diabetes mellitus. Sci Rep. 2020;10(1):14158.